[Pathophysiology of ischemia-reperfusion injury in renal transplantation]

Ischemia-reperfusion injury is a serious complication of organ transplantation. Renal ischemic and reperfusion injury is a multifactorial process that leads to organ damage and primary graft dysfunction and is a significant factor in kidney allograft destruction. In addition, several clinical studies report an apparent synergy between the initial injuries of ischemia-reperfusion and acute rejection. Initial non-specific injury leads to the establishment of a cytokine/adhesion molecule cascade and contributes to the development of chronic transplant failure. Reactive oxygen species generated during the reperfusion of an ischemic kidney, as well as mitochondrial defect, are essentially involved in postischemic microvascular injury. Ischemia-reperfusion injury is also an acute inflammatory process intimately involving leukocytes. In this review, we summarize the current data on the mechanisms of ischemia-reperfusion injury during renal transplantation.