The effects of brain death and ischemia on tolerance induction are organ-specific.

Autor: Michel SG; Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.; Clinic of Cardiac Surgery, Ludwig-Maximilian University Munich, Munich, Germany., Madariaga MLL; Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., LaMuraglia GM 2nd; Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.; Department of Surgery, Emory Transplant Center, Emory University School of Medicine, Atlanta, GA, USA., Villani V; Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Sekijima M; Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.; Division of Organ Replacement and Xenotransplantation Surgery, Kagoshima University, Kagoshima, Japan., Farkash EA; Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.; Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA., Colvin RB; Department of Pathology, Massachusetts General Hospital, Boston, MA, USA., Sachs DH; Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.; Department of Surgery, Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA., Yamada K; Department of Surgery, Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA., Rosengard BR; Johnson and Johnson, New Brunswick, NJ, USA., Allan JS; Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.; Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Madsen JC; Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.; Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Jazyk: angličtina
Zdroj: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2018 May; Vol. 18 (5), pp. 1262-1269. Date of Electronic Publication: 2018 Mar 05.
DOI: 10.1111/ajt.14674
Abstrakt: We have previously shown that 12 days of high-dose calcineurin inhibition induced tolerance in MHC inbred miniature swine receiving MHC-mismatched lung, kidney, or co-transplanted heart/kidney allografts. However, if lung grafts were procured from donation after brain death (DBD), and transplanted alone, they were rejected within 19-45 days. Here, we investigated whether donor brain death with or without allograft ischemia would also prevent tolerance induction in kidney or heart/kidney recipients. Four kidney recipients treated with 12 days of calcineurin inhibition received organs from donors rendered brain dead for 4 hours. Six heart/kidney recipients also treated with calcineurin inhibition received organs from donors rendered brain dead for 4 hours, 8 hours, or 4 hours with 4 additional hours of cold storage. In contrast to lung allograft recipients, all isolated kidney or heart/kidney recipients that received organs from DBD donors achieved long-term survival (>100 days) without histologic evidence of rejection. Proinflammatory cytokine gene expression was upregulated in lungs and hearts, but not kidney allografts, after brain death. These data suggest that the deleterious effects of brain death and ischemia on tolerance induction are organ-specific, which has implications for the application of tolerance to clinical transplantation.
(© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.)
Databáze: MEDLINE
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