On the intraoperative molecular status of renal allografts after vascular reperfusion and clinical outcomes.

Authors:
Yingyos Avihingsanon
Yingyos Avihingsanon
Chulalongkorn University
Thailand
Naili Ma
Naili Ma
New Jersey Medical School
United States
Martha Pavlakis
Martha Pavlakis
Beth Israel Deaconess Medical Center
Boston | United States
Marc E Uknis
Marc E Uknis
University of Massachusetts Medical School
United States
Anthony P Monaco
Anthony P Monaco
University of Oxford
United Kingdom
Christiane Ferran
Christiane Ferran
Beth Israel Deaconess Medical Center
Israel

J Am Soc Nephrol 2005 Jun 11;16(6):1542-8. Epub 2005 May 11.

Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA, USA.

Many hypothesize that subtle inflammation and immune activity detected in the intraoperative period are linked to adverse postkidney transplant clinical outcomes. To this end, renal allografts were analyzed for expression of pro-inflammatory, inflammation-induced adhesion molecules, immune activation as well as anti-apoptotic genes expressed 15 min after vascular reperfusion (zero-hour) to determine whether this analysis can aid in predicting the occurrence of delayed graft function (DGF), acute rejection (AR), and the quality of graft function at 6 mo. Intraoperative biopsies were obtained from 75 consecutively performed renal allografts in which consent was obtained 15 min after vascular reperfusion. These biopsies were analyzed by quantitative real-time PCR for transcription of 15 select genes and by standard histopathology. Posttransplant clinical outcomes were also analyzed in respect to intraoperative transcriptional profiles and clinical parameters available at the time of transplantation. This study demonstrates that a limited and hypothesis-driven PCR-based transcriptional profile of the zero-hour kidney biopsy predicts posttransplant clinical outcomes including DGF, early AR, and the quality of renal function 6 mo posttransplantation. For some clinical endpoints, the combined use of molecular analysis and established clinical indicators available at the time of transplantation further enhances the quality of prognosis. The transcriptional profiling data provide absolutely essential data to the predictive models, particularly with respect to AR and renal function 6 mo posttransplantation.

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Source
http://dx.doi.org/10.1681/ASN.2005020210DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1350948PMC

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June 2005
50 Reads
9 Citations
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