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Apoptosis of tubular epithelial cells in preimplantation biopsies of kidney grafts with immediate, slow and delayed function

Robert Krol, Jerzy Chudek, Henryk Karkoszka, Jacek Ziaja, Aurel Kolonko, Jacek Pawlicki, Maciej Kajor, Andrzej Wiecek, Lech Cierpka

Ann Transplant 2011; 16(3): 17-22

ID: 881990

Background:    Apoptosis is a form of cell death observed in kidney grafts as a result of ischemia/reperfusion injury. The aim of our prospective study was to analyze the intensity of apoptosis in kidney tubules after cold storage in respect to early and 12-month post-transplant graft function.
    Material/Methods:    The intensity of renal tubular apoptosis was estimated by TUNEL method in proximal and distal tubules in 72 pre-implantation kidney biopsies. Sixteen patients with biopsies that did not fulfill Banff 97 classification, with early acute rejection or early graft loss, were excluded. Early graft function was defined as IGF (N=17) when serum creatinine (sCr) was <264 µmol/l at 3rd postoperative day (POD); as SGF (N=20) when sCr >264 µmol/l and not more than 1 dialysis was performed; and as DGF (N=19) when more than 1 dialysis was done.
    Results:    The percentage of apoptotic cells was markedly higher in distal than in proximal tubules in all 3 groups. The percentage of apoptotic cells in distal tubules found was: 3.02% (1.03–5.00%) in IGF, 1.66% (0.92–2.39%) in SGF, and 1.76% (0.84–2.68%) in DGF; these differences were not significant. In the IGF group the mean percentage of apoptotic cells in distal tubule was higher than in the other groups (not statistically significant). The subgroups of patients with higher and lower than median (1.35%) apoptotic cell range in distal tubules had similar graft function at the 12-month follow-up.
    Conclusions:    The enhancement of tubular epithelial cells apoptosis in kidney grafts after cold storage does not determine its early and later excretory function.

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