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Bilateral native nephrectomy improves renal isograft function in rats.

T M Coffman, F P Sanfilippo, P C Brazy

    Kidney International
    |July 1, 1986
    PubMed
    Summary
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    Removing native kidneys before kidney transplant improves graft function. Native kidneys impair transplant function, but obstruction prevents this effect, suggesting excretory function is key.

    Area of Science:

    • Nephrology
    • Transplantation Immunology
    • Experimental Nephrology

    Background:

    • Native kidneys may negatively impact renal allograft survival, particularly in cases of acute tubular necrosis.
    • The influence of native kidney function on transplanted kidney outcomes requires further investigation.

    Purpose of the Study:

    • To investigate the impact of native kidney presence and function on the outcome of transplanted kidneys in a syngeneic rat model.
    • To determine if native kidney excretory function, rather than mere presence, affects transplanted kidney performance.

    Main Methods:

    • Lewis rat renal isografts were transplanted into littermates subjected to sham, unilateral, or bilateral native nephrectomy.
    • A separate group received transplants into rats with bilaterally obstructed native kidneys.

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  • In vivo measurements of renal blood flow and excretory function (inulin and PAH clearance) were performed eight days post-transplantation.

    • Main Results:

    • Isograft excretory function in rats with bilateral native nephrectomy was comparable to normal native kidneys.
    • The presence of functioning native kidneys significantly reduced isograft inulin clearance, PAH clearance, and blood flow.
    • Isografts in rats with obstructed native kidneys showed no significant impairment in clearance or blood flow.

    Conclusions:

    • Native kidney excretory function negatively impacts transplanted kidney performance.
    • Bilateral native nephrectomy, by removing excretory capacity, normalizes transplanted kidney function.
    • These findings highlight the importance of native kidney status in managing kidney transplant outcomes.