title: Non-invasive magnetic resonance imaging in rats for prediction of the fate of grafted kidneys from cardiac death donors.
abstract: The main objective of this study was to assess cardiac death (CD) kidney grafts before transplantation to determine whether blood oxygen level-dependent (BOLD) and diffusion MRI techniques can predict damage to these grafts after transplantation. We assessed CD kidney tissue by BOLD and diffusion MRI. We also examined pathological and gene expression changes in CD kidney grafts before and after transplantation. Although there was significantly more red cell congestion (RCC) in the inner stripe of the outer medulla (IS) in both 1 h after cardiac death (CD1h) and CD2h kidneys destined for grafts before transplantation compared with CD0h (p<0.05), CD2h, but not CD1h, kidney grafts had significantly different RCC in the IS 2 days after transplantation (p<0.05). Consistent with these pathological findings, tissue plasminogen activator (tPA) gene expression was increased only in the cortex and medulla of CD2h kidney grafts after transplantation. BOLD MRI successfully and non-invasively imaged and quantified RCC in the IS in both CD1h and CD2h kidney grafts (p<0.05). Diffusion MRI also non-invasively assessed increased the apparent diffusion coefficient in the IS and decreased it in the outer stripe (OS) of CD2h grafts, in concordance with interstitial edema in the IS and tubule cellular edema in the OS. These two types of edema in the outer medulla could explain the prolonged RCC in the IS only of CD2h kidney grafts, creating part of a vicious cycle inhibiting red cells coming out of capillary vessels in the IS. Perfusion with University of Wisconsin solution before MRI measurements did not diminish the difference in tissue damage between CD1h and CD2h kidney grafts. BOLD and diffusion MRI, which are readily available non-invasive tools for evaluating CD kidney grafts tissue damage, can predict prolonged organ damage, and therefore the outcome, of transplanted CD kidney grafts.
authors.affiliation: Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Jun-Ya
authors.initials: JY
authors.lastname: Kaimori
authors.forename: Satomi
authors.initials: S
authors.lastname: Iwai
authors.forename: Masaki
authors.initials: M
authors.lastname: Hatanaka
authors.forename: Takumi
authors.initials: T
authors.lastname: Teratani
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Obi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Tsuda
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Isaka
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokawa
authors.forename: Kagayaki
authors.initials: K
authors.lastname: Kuroda
authors.forename: Naotsugu
authors.initials: N
authors.lastname: Ichimaru
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Okumi
authors.forename: Koji
authors.initials: K
authors.lastname: Yazawa
authors.forename: Hiromi
authors.initials: H
authors.lastname: Rakugi
authors.forename: Norio
authors.initials: N
authors.lastname: Nonomura
authors.forename: Shiro
authors.initials: S
authors.lastname: Takahara
authors.forename: Eiji
authors.initials: E
authors.lastname: Kobayashi
mesh_terms: D000241:Adenosine; D000493:Allopurinol; D000818:Animals; D003643:Death; D004058:Diffusion; D004912:Erythrocytes / Q000378:metabolism; D020869:Gene Expression Profiling; D005978:Glutathione; D007328:Insulin; D007672:Kidney Cortex / Q000378:metabolism; D007679:Kidney Medulla / Q000378:metabolism / Q000473:pathology; D016030:Kidney Transplantation; D008279:Magnetic Resonance Imaging; D019188:Organ Preservation Solutions; D010100:Oxygen / Q000097:blood; D011887:Raffinose; D051381:Rats; D011917:Rats, Inbred Lew
chemical_list: D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose; D010100:Oxygen