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A Quantitative Detection Method for MicroRNAs in the Kidney of an Ischemic Kidney Injury Mouse Model
Published on: September 11, 2020
Gene expression and biomarkers in renal transplant ischemia reperfusion injury
Paul Perco1, Clara Pleban, Alexander Kainz
1Krankenhaus der Elisabethinen, Linz, Austria.
Abstract:
The incidence of postischemic acute renal allograft failure (ARF) occurs in roughly 25% of cadaveric donor kidney recipients. This high rate remained virtually unchanged over the last decades despite modification in recipient management and modern immunosuppressive strategies. It has recently been shown that among other reasons, the systemic inflammation in the brain death cadaveric organ donor contributes to subsequent ARF in the recipient. This review focuses on the consequences of ischemia and reperfusion on the cellular level and offers potential solutions for the reduction of ARF. Genome-wide gene expression analysis together with sophisticated biostatistical analysis made it possible to identify several candidate gene products and proteins that may act as specific and sensitive biomarker for renal inflammation and ischemia. These markers may be very helpful in the clinical management of patients with a high a priori risk of subsequent ARF such as recipients of marginal donor kidneys. Ongoing clinical trials will evaluate whether immunosuppression of the cadaveric organ donor before organ harvest will have the potential to reduce inflammation in the transplant kidney and subsequently lead to a reduction in the rate of ARF.
Insights
Postischemic acute renal allograft failure (ARF) affects 25% of kidney transplant recipients. Reducing donor inflammation may decrease ARF rates, with new biomarkers aiding high-risk patient management.
Area of Science:
- Nephrology
- Transplantation Immunology
- Genomics
Background:
- Postischemic acute renal allograft failure (ARF) affects approximately 25% of cadaveric donor kidney recipients.
- This high incidence has persisted despite advancements in recipient management and immunosuppression.
- Systemic inflammation in brain-dead organ donors is increasingly recognized as a contributor to subsequent ARF.
Purpose of the Study:
- To review the cellular consequences of ischemia and reperfusion injury in kidney allografts.
- To explore potential strategies for reducing ARF.
- To identify novel biomarkers for renal inflammation and ischemia.
Main Methods:
- Review of existing literature on ischemia-reperfusion injury and ARF.
- Analysis of genome-wide gene expression data.
- Application of sophisticated biostatistical methods to identify candidate biomarkers.
Main Results:
- Identification of specific gene products and proteins as potential biomarkers for renal inflammation and ischemia.
- These biomarkers may assist in managing patients at high risk for ARF, such as recipients of marginal donor kidneys.
Conclusions:
- Donor-directed immunosuppression prior to organ procurement is being investigated as a strategy to mitigate inflammation in the transplanted kidney.
- Reducing inflammation may lead to a decreased incidence of ARF.
- Biomarker discovery offers new avenues for clinical management and risk stratification in kidney transplantation.
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