Related Experiment Video
Updated: Jun 8, 2026
Murine Kidney Transplant Technique
Published on: October 20, 2015
Leukocyte and platelet depletion improves blood flow and function in a renal transplant model
Phillip J Yates1, Sarah A Hosgood, Michael L Nicholson
1Department of Infection, Immunity, and Inflammation, Transplant Surgery Group, Leicester General Hospital, Leicester, United Kingdom. pjy4@le.ac.uk
Insights
Reperfusion with leukocyte-depleted blood improved renal blood flow and function in a porcine kidney transplant model. However, this alone did not fully reverse ischemic injury in donation after cardiac death kidneys.
Area of Science:
- Transplantation immunology
- Renal physiology
- Organ preservation
Background:
- Donation after cardiac death (DCD) kidneys are vital for transplantation but suffer significant ischemic injury.
- This injury leads to delayed graft function (DGF) and primary non-function (PNF) due to reperfusion insult.
- Leukocytes play a critical role in mediating reperfusion injury.
Purpose of the Study:
- To evaluate the impact of reperfusion with leukocyte and platelet-depleted blood (LDB) versus whole blood (WB) on DCD kidney function.
- To assess renal blood flow, function, and injury markers in an ex vivo porcine model.
Main Methods:
- Utilized an ex vivo porcine kidney transplantation model.
- Compared reperfusion with LDB versus WB.
- Recorded hemodynamic measurements and analyzed biochemical, hematological, and histological samples.
Main Results:
- LDB reperfusion significantly improved renal blood flow compared to WB.
- Creatinine clearance and renal oxygen consumption were significantly enhanced with LDB.
- No significant improvements were observed in fractional excretion of sodium, acid-base balance, urinary nitric oxide, or 8-isoprostane levels.
Conclusions:
- Improved blood flow from LDB reperfusion offers partial benefits to DCD kidneys.
- Enhanced blood flow alone is insufficient to fully counteract severe ischemic damage.
- The porcine model provides insights into early reperfusion dynamics in renal transplantation.
Background:
Donation after cardiac death (DCD) donors are an important source of organs for transplantation. Due to warm and cold ischemic injury, DCD kidneys undergo a significant reperfusion insult when transplanted. This is manifested clinically as a high incidence of delayed graft function (DGF) and primary non-function (PNF). The importance of leukocytes in the generation of reperfusion injury is pivotal.
Methods:
Using an ex vivo porcine model of kidney transplantation, the effects of reperfusion with leukocyte and platelet depleted blood (LDB) and whole blood (WB) on renal blood flow and function were compared. Hemodynamic measurements were recorded, and biochemical, hematological, and histologic samples taken at set time-points.
Results:
Reperfusion with LDB improved renal blood flow significantly compared with WB reperfusion. In addition, there was a significant improvement in creatinine clearance and renal oxygen consumption, but not fractional excretion of sodium, acid-base homeostasis, urinary nitric oxide (NO), or 8-isoprostane levels.
Conclusions:
This study represents a good model for the initial reperfusion period in renal transplantation. Improvement in only some functional markers and neither urinary NO nor 8-isoprostane levels indicates that improved blood flow alone is not sufficient to reverse the severe ischemic insult endured by DCD kidneys.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:16Kidney Transplant III: Nursing Management
01:26Kidney Transplant II: Surgical Procedure
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy the...