PMID- 10504507
OWN - NLM
STAT- MEDLINE
DCOM- 19991202
LR  - 20131121
IS  - 0085-2538 (Print)
IS  - 0085-2538 (Linking)
VI  - 56
IP  - 4
DP  - 1999 Oct
TI  - Cadaver versus living donor kidneys: impact of donor factors on antigen induction 
      before transplantation.
PG  - 1551-9
AB  - BACKGROUND: It is widely recognized that living-related donor (LRD) renal 
      allografts have a higher overall graft survival than cadaver donor transplants. 
      We tested the hypothesis that part of this is attributable to LRD kidneys being 
      obtained under optimal conditions from healthy donors, whereas cadaveric kidneys 
      may have experienced injury as a result of inflammatory events around the time of 
      brain death. METHODS: We have performed a comparative immunohistochemical 
      analysis of pretransplant donor biopsies from cadaveric (N = 65) and LRD (N = 29) 
      kidneys to determine any differences that may predispose them to subsequent 
      damage. Cryostat sections were stained with antibodies to leukocytes, adhesion 
      molecules, and human leukocyte antigen (HLA)-DR antigens, and the expression was 
      assessed semiquantitatively. RESULTS: High levels of endothelial E-selectin and 
      proximal tubular expression of HLA-DR antigens, intercellular adhesion 
      molecule-1, and vascular cell adhesion molecule-1 were detected in biopsies from 
      cadaveric kidneys, whereas expression of these markers was markedly reduced in 
      LRD kidneys. High levels of tubular antigen expression were significantly 
      associated with traumatic death, prolonged ventilation, and episodes of infection 
      in cadaver donors. Furthermore, the expression of pretransplant tubular antigens 
      in cadaver donor kidneys was significantly associated with early acute rejection 
      following transplantation, suggesting that such kidneys are predisposed to 
      subsequent immune-mediated attack following transplantation. CONCLUSIONS: These 
      results may explain, in part, the superior outcome of LRD allografts compared 
      with cadaver renal allografts.
FAU - Koo, D D
AU  - Koo DD
AD  - Nuffield Department of Surgery and Oxford Transplant Center, University of 
      Oxford, John Radcliffe Hospital, England, United Kingdom.
FAU - Welsh, K I
AU  - Welsh KI
FAU - McLaren, A J
AU  - McLaren AJ
FAU - Roake, J A
AU  - Roake JA
FAU - Morris, P J
AU  - Morris PJ
FAU - Fuggle, S V
AU  - Fuggle SV
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Kidney Int
JT  - Kidney international
JID - 0323470
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (E-Selectin)
RN  - 0 (HLA-DR Antigens)
RN  - 0 (Histocompatibility Antigens Class II)
RN  - 0 (P-Selectin)
RN  - 0 (Renal Agents)
RN  - 0 (Vascular Cell Adhesion Molecule-1)
RN  - 126547-89-5 (Intercellular Adhesion Molecule-1)
RN  - ENR1LLB0FP (Deamino Arginine Vasopressin)
SB  - IM
MH  - Adult
MH  - Antibodies, Monoclonal
MH  - Biopsy
MH  - Cadaver
MH  - Deamino Arginine Vasopressin/administration & dosage
MH  - E-Selectin/analysis
MH  - Endothelium/chemistry/immunology/metabolism
MH  - Female
MH  - Graft Survival/drug effects/*immunology
MH  - HLA-DR Antigens/analysis/metabolism
MH  - Histocompatibility Antigens Class II/*analysis/immunology/metabolism
MH  - Humans
MH  - Intensive Care Units
MH  - Intercellular Adhesion Molecule-1/analysis/metabolism
MH  - Kidney Transplantation/*immunology
MH  - Kidney Tubules, Proximal/chemistry/immunology/pathology
MH  - *Living Donors
MH  - Male
MH  - Middle Aged
MH  - P-Selectin/analysis
MH  - Renal Agents/administration & dosage
MH  - *Transplantation Immunology
MH  - Transplantation, Homologous
MH  - Vascular Cell Adhesion Molecule-1/analysis/metabolism
EDAT- 1999/10/03 00:00
MHDA- 1999/10/03 00:01
CRDT- 1999/10/03 00:00
PHST- 1999/10/03 00:00 [pubmed]
PHST- 1999/10/03 00:01 [medline]
PHST- 1999/10/03 00:00 [entrez]
AID - S0085-2538(15)46464-6 [pii]
AID - 10.1046/j.1523-1755.1999.00657.x [doi]
PST - ppublish
SO  - Kidney Int. 1999 Oct;56(4):1551-9. doi: 10.1046/j.1523-1755.1999.00657.x.