engleski

Increased Renal Tubular Cell Apoptosis in Donation after Cardiac Death (DCD) Kidneys Compared with Standard Criteria Donor (SCD) Kidneys

Background: DCD kidneys suffer increased DGF due to warm and cold ischemia (CI). The effect of pulsatile perfusion (PP) vs. static preservation (SP) on apoptotic pathways is unknown. In a porcine model of DCD, we hypothesized that DCD kidneys have increased apoptosis and caspase-3, and reduced X-linked inhibitor of apoptosis (XIAP) protein compared with SCD kidneys. We also sought to determine whether PP protected DCD kidneys by reducing apoptosis and increasing XIAP expression. Methods: Male Yorkshire pigs subjected to cardiac death were perfused with cold UW solution and subjected to SP or PP for 24 hrs. Kidney biopsies were obtained at 0 and 24 hrs of CI. Apoptotic renal tubular cells (RTE) were quantitated by a renal pathologist. SCD kidneys not subjected to cardiac death were used as controls. Immunoblot was used to assess active caspase-3 (17kDa) and XIAP(53kDa). Results: Apoptotic RTEs and caspase-3 expression were significantly increased in DCD vs SCD kidneys whereas XIAP and BCL-XL expression were not detected in DCD kidneys. Next we hypothesized that DCD kidneys subjected to PP would have less apoptosis and increased XIAP expression vs. DCD kidneys stored by SP. PP significantly reduced RTE apoptosis in DCD kidneys but was not associated with increased XIAP expression. Conclusions: These findings suggest that DCD kidneys experience more RTE apoptosis vs. SCD kidneys associated with loss of anti-apoptotic XIAP and BCL-XL protein expression. DCD kidneys subjected to PP had significantly decreased apoptosis that was independent of caspase-3 and XIAP protein expression.

Renal Tubular Cell Apoptosis; Cardiac Death Kidneys; Standard Criteria Donor Kidneys

nije evidentirano