Ischemia and reperfusion injury in renal transplantation: hemodynamic and immunological paradigms
Main Author: | |
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Publication Date: | 2015 |
Other Authors: | , , |
Format: | Article |
Language: | eng |
Source: | Einstein (São Paulo) |
Download full: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082015000100023 |
Summary: | Ischemia and reperfusion injury is an inevitable event in renal transplantation. The most important consequences are delayed graft function, longer length of stay, higher hospital costs, high risk of acute rejection, and negative impact of long-term follow-up. Currently, many factors are involved in their pathophysiology and could be classified into two different paradigms for education purposes: hemodynamic and immune. The hemodynamic paradigm is described as the reduction of oxygen delivery due to blood flow interruption, involving many hormone systems, and oxygen-free radicals produced after reperfusion. The immune paradigm has been recently described and involves immune system cells, especially T cells, with a central role in this injury. According to these concepts, new strategies to prevent ischemia and reperfusion injury have been studied, particularly the more physiological forms of storing the kidney, such as the pump machine and the use of antilymphocyte antibody therapy before reperfusion. Pump machine perfusion reduces delayed graft function prevalence and length of stay at hospital, and increases long-term graft survival. The use of antilymphocyte antibody therapy before reperfusion, such as Thymoglobulin™, can reduce the prevalence of delayed graft function and chronic graft dysfunction. |
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Ischemia and reperfusion injury in renal transplantation: hemodynamic and immunological paradigmsReperfusion injuryIschemiaDelayed graft functionGraft rejectionPerfusion/utilizationIschemia and reperfusion injury is an inevitable event in renal transplantation. The most important consequences are delayed graft function, longer length of stay, higher hospital costs, high risk of acute rejection, and negative impact of long-term follow-up. Currently, many factors are involved in their pathophysiology and could be classified into two different paradigms for education purposes: hemodynamic and immune. The hemodynamic paradigm is described as the reduction of oxygen delivery due to blood flow interruption, involving many hormone systems, and oxygen-free radicals produced after reperfusion. The immune paradigm has been recently described and involves immune system cells, especially T cells, with a central role in this injury. According to these concepts, new strategies to prevent ischemia and reperfusion injury have been studied, particularly the more physiological forms of storing the kidney, such as the pump machine and the use of antilymphocyte antibody therapy before reperfusion. Pump machine perfusion reduces delayed graft function prevalence and length of stay at hospital, and increases long-term graft survival. The use of antilymphocyte antibody therapy before reperfusion, such as Thymoglobulin™, can reduce the prevalence of delayed graft function and chronic graft dysfunction.Instituto Israelita de Ensino e Pesquisa Albert Einstein2015-03-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082015000100023einstein (São Paulo) v.13 n.1 2015reponame:Einstein (São Paulo)instname:Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE)instacron:IIEPAE10.1590/S1679-45082015RW3161info:eu-repo/semantics/openAccessRequião-Moura,Lúcio RobertoDurão Junior,Marcelino de SouzaMatos,Ana Cristina Carvalho dePacheco-Silva,Alvaroeng2015-08-03T00:00:00Zoai:scielo:S1679-45082015000100023Revistahttps://journal.einstein.br/pt-br/ONGhttps://old.scielo.br/oai/scielo-oai.php||revista@einstein.br2317-63851679-4508opendoar:2015-08-03T00:00Einstein (São Paulo) - Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE)false |
dc.title.none.fl_str_mv |
Ischemia and reperfusion injury in renal transplantation: hemodynamic and immunological paradigms |
title |
Ischemia and reperfusion injury in renal transplantation: hemodynamic and immunological paradigms |
spellingShingle |
Ischemia and reperfusion injury in renal transplantation: hemodynamic and immunological paradigms Requião-Moura,Lúcio Roberto Reperfusion injury Ischemia Delayed graft function Graft rejection Perfusion/utilization |
title_short |
Ischemia and reperfusion injury in renal transplantation: hemodynamic and immunological paradigms |
title_full |
Ischemia and reperfusion injury in renal transplantation: hemodynamic and immunological paradigms |
title_fullStr |
Ischemia and reperfusion injury in renal transplantation: hemodynamic and immunological paradigms |
title_full_unstemmed |
Ischemia and reperfusion injury in renal transplantation: hemodynamic and immunological paradigms |
title_sort |
Ischemia and reperfusion injury in renal transplantation: hemodynamic and immunological paradigms |
author |
Requião-Moura,Lúcio Roberto |
author_facet |
Requião-Moura,Lúcio Roberto Durão Junior,Marcelino de Souza Matos,Ana Cristina Carvalho de Pacheco-Silva,Alvaro |
author_role |
author |
author2 |
Durão Junior,Marcelino de Souza Matos,Ana Cristina Carvalho de Pacheco-Silva,Alvaro |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Requião-Moura,Lúcio Roberto Durão Junior,Marcelino de Souza Matos,Ana Cristina Carvalho de Pacheco-Silva,Alvaro |
dc.subject.por.fl_str_mv |
Reperfusion injury Ischemia Delayed graft function Graft rejection Perfusion/utilization |
topic |
Reperfusion injury Ischemia Delayed graft function Graft rejection Perfusion/utilization |
description |
Ischemia and reperfusion injury is an inevitable event in renal transplantation. The most important consequences are delayed graft function, longer length of stay, higher hospital costs, high risk of acute rejection, and negative impact of long-term follow-up. Currently, many factors are involved in their pathophysiology and could be classified into two different paradigms for education purposes: hemodynamic and immune. The hemodynamic paradigm is described as the reduction of oxygen delivery due to blood flow interruption, involving many hormone systems, and oxygen-free radicals produced after reperfusion. The immune paradigm has been recently described and involves immune system cells, especially T cells, with a central role in this injury. According to these concepts, new strategies to prevent ischemia and reperfusion injury have been studied, particularly the more physiological forms of storing the kidney, such as the pump machine and the use of antilymphocyte antibody therapy before reperfusion. Pump machine perfusion reduces delayed graft function prevalence and length of stay at hospital, and increases long-term graft survival. The use of antilymphocyte antibody therapy before reperfusion, such as Thymoglobulin™, can reduce the prevalence of delayed graft function and chronic graft dysfunction. |
publishDate |
2015 |
dc.date.none.fl_str_mv |
2015-03-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082015000100023 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082015000100023 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1679-45082015RW3161 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Instituto Israelita de Ensino e Pesquisa Albert Einstein |
publisher.none.fl_str_mv |
Instituto Israelita de Ensino e Pesquisa Albert Einstein |
dc.source.none.fl_str_mv |
einstein (São Paulo) v.13 n.1 2015 reponame:Einstein (São Paulo) instname:Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE) instacron:IIEPAE |
instname_str |
Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE) |
instacron_str |
IIEPAE |
institution |
IIEPAE |
reponame_str |
Einstein (São Paulo) |
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Einstein (São Paulo) |
repository.name.fl_str_mv |
Einstein (São Paulo) - Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE) |
repository.mail.fl_str_mv |
||revista@einstein.br |
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1752129907856506880 |