The role of nitric oxide and inflammatory cytokines in delayed graft function of DCD renal transplants : the effect of induction immunosuppression

• Main Author: Johns, Rosemary
• Published: Cardiff University 2018
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.753581

Ischemia Reperfusion Injury (IRI) has a significant influence on patient outcomes after renal transplantation. The role of Nitric Oxide (NO) in IRI is controversial with evidence for both protective and deleterious effects. The aim of this project was to investigate NO in recipients of Donation After Cardiac Death (DCD) renal transplants, who are expected to have high rates of Delayed Graft Function (DGF) as a result of IRI, and to correlate this with their inflammatory response and induction immunosuppression. Methods Plasma samples were collected from 35 recipients of DCD renal transplants around the time of transplantation. NO2- and NO3- were measured using the Griess reaction and Ozone chemiluminescence and cytokines were measured using Luminex. Results At 2 and 8 hours post reperfusion of the transplanted kidney changes in NO2- were associate with the age of the recipient (p = 0.05 and 0.001 respectively) and at 8 hours very strongly related to the warm ischemic time (p < 0.0005). At 8 hours post reperfusion there was a strong negative correlation between the age of the recipient and the change of NO3- (p = 0.002). IL-6 and IL-10 were found to increase significantly at 30 minutes and 2 hours after reperfusion (p < 0.0005). IL-6, IL-10 and TNF-α were all influenced significantly by induction immunosuppression and at 30 minutes post reperfusion changes in NO2- were also affected by the induction. IV Conclusion Changes in NO2- were influenced by factors effecting renal IRI and also by induction immunosuppression. Increasing age was associated with dampening of the NO2- and NO3- response. Cytokines levels rose after reperfusion of the kidney and their changes were modified by induction immunosuppression.