title: Is microdialysis useful for early detection of acute rejection after kidney transplantation?
abstract: BACKGROUND
  Acute rejection following kidney transplantation (KTx) is still one of the challenging complications leading to chronic allograft failure. The aim of this study was to investigate the role of microdialysis (MD) in the early detection of acute graft rejection factor following KTx in porcine model.
  
  
  METHODS
  Sixteen pigs were randomized after KTx into case (n = 8, without immunosuppressant) and control groups (n = 8, with immunosuppressant). The rejection diagnosis in our groups was confirmed by histopathological evidences as "acute borderline rejection". Using MD, we monitored the interstitial concentrations of glucose, lactate, pyruvate, glutamate and glycerol in the transplanted grafts after reperfusion.
  
  
  RESULTS
  In the early post-reperfusion phase the lactate level in our case group was significantly higher comparing to the control group and remained in higher levels until the end of monitoring. The lactate to pyruvate ratio showed a considerable increase in the case group during the post-reperfusion phase. The other metabolites (glucose, glycerol, glutamate) were nearly at the same levels at the end of our monitoring in both study groups.
  
  
  CONCLUSIONS
  The increase in lactate and lactate to pyruvate ratios seems to be an indicator for early detection of acute rejection after KTx. Therefore, MD as a minimally invasive measurement tool may help to identify the need to immunosuppression adjustment in the early KTx phase before the clinical manifestation of the rejection.
authors: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
authors: Hamidreza
authors: H
authors: Fonouni
authors: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
authors: Mohammad
authors: M
authors: Golriz
authors: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
authors: Ali
authors: A
authors: Majlesara
authors: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
authors: Alireza
authors: A
authors: Faridar
authors: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
authors: Majid
authors: M
authors: Esmaeilzadeh
authors: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
authors: Parvin
authors: P
authors: Jarahian
authors: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
authors: Morva Tahmasbi
authors: MT
authors: Rad
authors: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
authors: Mohammadreza
authors: M
authors: Hafezi
authors: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
authors: Camelia
authors: C
authors: Garoussi
authors: Department of Pathology, University of Heidelberg, Heidelberg, Germany.
authors: Stephan
authors: S
authors: Macher-Goeppinger
authors: Department of Pathology, University of Heidelberg, Heidelberg, Germany.
authors: Thomas
authors: T
authors: Longerich
authors: Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany.
authors: Berk
authors: B
authors: Orakcioglu
authors: Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany.
authors: Oliver W
authors: OW
authors: Sakowitz
authors: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany. Electronic address: arianeb_mehrabi@med.uni-heidelberg.de.
authors: Arianeb
authors: A
authors: Mehrabi
mesh_terms: D000208:Acute Disease; D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D004195:Disease Models, Animal; D042241:Early Diagnosis; D005947:Glucose / Q000378:metabolism; D005990:Glycerol / Q000378:metabolism; D006084:Graft Rejection / Q000175:diagnosis*; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D019344:Lactic Acid / Q000378:metabolism; D017551:Microdialysis / Q000379:methods*; D008991:Monitoring, Physiologic / Q000379:methods; D019289:Pyruvic Acid / Q000378:metabolism; D034421:Sus scrofa
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents; D019344:Lactic Acid; D019289:Pyruvic Acid; D005947:Glucose; D005990:Glycerol
keywords: Acute rejection; Kidney transplantation; Metabolic changes; Microdialysis