Early outcome in renal transplantation from large donors to small and size-matched recipients - A porcine experimental model

Ravlo K, Chhoden T, Sondergaard P, Secher N, Keller AK, Pedersen M, Bibby BM, Moldrup U, Ostraat EO, Birn H, Norregaard R, Marcussen N, Leuvenink HG, Jespersen B. Early outcome in renal transplantation from large donors to small and size-matched recipients A porcine experimental model. Abstract: Kidney transplantation from a large donor to a small recipient, as in pediatric transplantation, is associated with an increased risk of thrombosis and DGF. We established a porcine model for renal transplantation from an adult donor to a small or size-matched recipient with a high risk of DGF and studied GFR, RPP using MRI, and markers of kidney injury within 10 h after transplantation. After induction of BD, kidneys were removed from similar to 63-kg donors and kept in cold storage for similar to 22 h until transplanted into small (similar to 15 kg, n = 8) or size-matched (n = 8) recipients. A reduction in GFR was observed in small recipients within 60 min after reperfusion. Interestingly, this was associated with a significant reduction in medullary RPP, while there was no significant change in the size-matched recipients. No difference was observed in urinary NGAL excretion between the groups. A significant higher level of HO-1 mRNA was observed in small recipients than in donors and size-matched recipients indicating cortical injury. Improvement in early graft perfusion may be a goal to improve short- and long-term GFR and avoid graft thrombosis in pediatric recipients. (c) 2012 John Wiley & Sons A/S.