The effect of ischemia/reperfusion on the kidney graft

Julia Menke, Daniel Sollinger, Beate Schamberger, Uwe Heemann, Jens Lutz

Research output: Contribution to journalReview articlepeer-review

84 Scopus citations

Abstract

Purpose of Review: Ischemia/reperfusion injury is an unavoidable companion after kidney transplantation and influences short-term as well as long-term graft outcome. Clinically ischemia/reperfusion injury is associated with delayed graft function, graft rejection, and chronic graft dysfunction. Ischemia/reperfusion affects many regulatory systems at the cellular level as well as in the renal tissue that eventually result in a distinct inflammatory reaction of the kidney graft. RECENT FINDINGS: Underlying factors include energy metabolism, cellular changes of the mitochondria and cellular membranes, initiation of different forms of cell death-like apoptosis and necrosis together with a recently discovered mixed form termed necroptosis. Chemokines and cytokines together with other factors promote the inflammatory response leading to activation of the innate immune system as well as the adaptive immune system. If the inflammatory reaction continues within the graft tissue, a progressive interstitial fibrosis develops that impacts long-term graft outcome. SUMMARY: It is of particular importance in kidney transplantation to understand the underlying mechanisms and effects of ischemia/reperfusion on the graft as this knowledge also opens strategies to prevent or treat ischemia/reperfusion injury after transplantation in order to improve graft outcome.

Original languageEnglish
Pages (from-to)395-400
Number of pages6
JournalCurrent Opinion in Organ Transplantation
Volume19
Issue number4
DOIs
StatePublished - Aug 2014
Externally publishedYes

Keywords

  • Adaptive immune system
  • Delayed graft function
  • Fibrosis
  • Innate immunity
  • Ischemia/reperfusion
  • Kidney transplantation
  • Necroptosis
  • Rejection
  • microrna

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