title: Matrix Metalloproteinase-9 and Graft Preservation Injury in Clinical Renal Transplantation.
abstract: BACKGROUND
  Deleterious effects of matrix metalloproteinase-9 (MMP-9) have been established in experimental renal ischemia-reperfusion models but not in clinical renal transplantation thus far.
  
  
  METHODS
  We studied MMP-9 and its physiological inhibitor tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in 45 consecutive patients of a larger trial in renal transplantation: perioperative anti-thymocyte globulin (group A, n = 15), perioperative basiliximab (group B, n = 16), and conventional triple therapy (group C, n = 14). In addition to systemic blood samples, local blood samples were obtained simultaneously at 1 and 5 minutes after reperfusion from iliac artery and graft vein for calculation of transrenal changes. Because anti-thymocyte globulin activates inflammation, group A was analyzed separately. Groups B and C were pooled (group BC).
  
  
  RESULTS
  Anti-thymocyte globulin infusion caused a robust rise of MMP-9 in the systemic circulation in group A. No significant transrenal difference of MMP-9 or TIMP-1 occurred in either group during graft reperfusion. In group BC, strong transrenal release of MMP-9 at 1 minute after reperfusion correlated with cold ischemia time (R = 0.66, P = .0001) and was associated with delayed graft function (P = .052).
  
  
  CONCLUSIONS
  Renal production of MMP-9 on graft reperfusion is associated with cold ischemia time and emergence of delayed graft function. MMP inhibition may offer a means to reduce reperfusion injury in renal transplantation.
authors.affiliation: Department of Surgery, Kanta-Häme Central Hospital, Hämeenlinna, Finland.
authors.forename: A J
authors.initials: AJ
authors.lastname: Turunen
authors.affiliation: Department of Anesthesiology, Tampere University Hospital, Tampere, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Lindgren
authors.affiliation: Department of Transplantation and Liver Surgery, Helsinki University Hospital, Helsinki, Finland.
authors.forename: K T
authors.initials: KT
authors.lastname: Salmela
authors.affiliation: Department of Transplantation and Liver Surgery, Helsinki University Hospital, Helsinki, Finland.
authors.forename: L E
authors.initials: LE
authors.lastname: Kyllönen
authors.affiliation: Children's Hospital, Helsinki University Hospital, Helsinki, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Andersson
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland. Electronic address: eero.pesonen@hus.fi.
authors.forename: E
authors.initials: E
authors.lastname: Pesonen
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D000961:Antilymphocyte Serum / Q000008:administration & dosage / Q000009:adverse effects; D000077552:Basiliximab; D050377:Cold Ischemia; D051799:Delayed Graft Function; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D016030:Kidney Transplantation; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage / Q000009:adverse effects; D015424:Reperfusion; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood
chemical_list: D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; C560822:TIMP1 protein, human; D019715:Tissue Inhibitor of Metalloproteinase-1; D000077552:Basiliximab; D020780:Matrix Metalloproteinase 9