Graft Neutrophil Sequestration and Concomitant Tissue Plasminogen Activator Release During Reperfusion in Clinical Kidney Transplantation

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Ilmakunnas , M , Turunen , A J , Lindgren , L , Salmela , K T , Kyllönen , L E , Andersson , S , Petäjä , J & Pesonen , E J 2019 , ' Graft Neutrophil Sequestration and Concomitant Tissue Plasminogen Activator Release During Reperfusion in Clinical Kidney Transplantation ' , Transplantation Proceedings , vol. 51 , no. 3 , pp. 647-650 . https://doi.org/10.1016/j.transproceed.2019.01.056

Title: Graft Neutrophil Sequestration and Concomitant Tissue Plasminogen Activator Release During Reperfusion in Clinical Kidney Transplantation
Author: Ilmakunnas, M.; Turunen, A. J.; Lindgren, L.; Salmela, K. T.; Kyllönen, L. E.; Andersson, S.; Petäjä, J.; Pesonen, E. J.
Contributor: University of Helsinki, Anestesiologian yksikkö
University of Helsinki, Department of Surgery
University of Helsinki, IV kirurgian klinikka
University of Helsinki, HUS Children and Adolescents
University of Helsinki, Children's Hospital
University of Helsinki, Clinicum
Date: 2019-04
Language: eng
Number of pages: 4
Belongs to series: Transplantation Proceedings
ISSN: 0041-1345
URI: http://hdl.handle.net/10138/315590
Abstract: Background. Inflammation, coagulation, and fibrinolysis are tightly linked together. Reperfusion after transient ischemia activates both neutrophils, coagulation, and fibrinolysis. Experimental data suggest that tissue plasminogen activator (tPA) regulates renal neutrophil influx in kidney ischemia and reperfusion injury. Methods. In 30 patients undergoing kidney transplantation, we measured renal neutrophil sequestration and tPA release from blood samples drawn from the supplying artery and renal vein early after reperfusion. tPA antigen levels were measured using a commercial enzyme-linked immunosorbent assay kit. For each parameter, transrenal difference (Delta) was calculated by subtracting the value of the arterial sample (ingoing blood) from the value of the venous sample (outgoing blood). Results. Positive transrenal gradients of tPA antigen occurred at 1 minute [Delta = 14 (3-46) ng/mL, P <.01] and 5 minutes [Delta = 5 (-3 to 27) ng/mL, P <.01] after reperfusion. At 5 minutes after reperfusion, a negative transrenal gradient of neutrophils was observed [Delta = -0.17 (-1.45 to 0.24) x 10E9 cells/L, P <.001]. At 1 minute after reperfusion, neutrophil sequestration into the kidney (ie, negative transrenal neutrophil count) correlated significantly with tPA release from the kidney (ie, positive transrenal tPA concentration), (R = -0.513 and P = .006). Conclusions. The findings suggest a proinflammatory role for tPA in ischemia and reperfusion injury in human kidney transplantation.
Subject: PROTEIN-C
COAGULATION
INFLAMMATION
COMPLEMENT
PROMOTES
INJURY
3126 Surgery, anesthesiology, intensive care, radiology
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