Abstract
© Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons Kidney transplants from living donors (LDs) have a better outcome than those from deceased donors (DDs). Different factors have been suggested to justify the different outcome. In this study, we analyzed the infiltration and phenotype of monocytes/macrophages and the expression of inflammatory and fibrotic markers in renal biopsy specimens from 94 kidney recipients (60 DDs and 34 LDs) at baseline and 4 months after transplantation. We evaluated their association with medium- and long-term renal function. At baseline, inflammatory gene expression was higher in DDs than in LDs. These results were confirmed by the high number of CD68-positive cells in DD kidneys, which correlated negatively with long-term renal function. Expression of the fibrotic markers vimentin, fibronectin, and α–smooth muscle actin was more elevated in biopsy specimens from DDs at 4 months than in those from LDs. Gene expression of inflammatory and fibrotic markers at 4 months and difference between 4 months and baseline correlated negatively with medium- and long-term renal function in DDs. Multivariate analysis point to transforming growth factor-β1 as the best predictor of long-term renal function in DDs. We conclude that early macrophage infiltration, sustained inflammation, and transforming growth factor-β1 expression, at least for the first 4 months, contribute significantly to the difference in DD and LD transplant outcome.
Original language | English |
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Pages (from-to) | 733-743 |
Journal | American Journal of Transplantation |
Volume | 17 |
Issue number | 3 |
DOIs | |
Publication status | Published - 1 Mar 2017 |
Keywords
- basic (laboratory) research/science
- biopsy
- donors and donation
- fibrosis
- graft survival
- kidney (allograft) function/dysfunction
- kidney transplantation/nephrology
- molecular biology
- translational research/science