Vth International Congress of the International Society for Organ Sharing
Distribution and predictive value of apoptosis in biopsies from non–heart-beating donor kidneys

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Methods

Thirty-one NHBD kidneys and 75 HBD kidneys were studied. The NHBDs received cardiac massage and pulmonary ventilation for the purposes of organ preservation after confirmation of brain-stem death. All kidneys were preserved by perfusion with Marshall solution and stored on ice. Tru-cut cortical biopsies were taken from all kidneys prior to reperfusion. The wax-embedded tissue was sectioned at 4 μm and stained using the terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick-end-labelling

Results

Positive staining, representing apoptotic cells, was consistently seen in the tonsillar control tissue. No positive staining was seen in the cortical tubular epithelial cells in any biopsies from either HBD or NHBD kidneys. However, in six of the biopsies from the NHBDs some juxtacortical renal medulla was included. Four of these showed small numbers of apoptotic medullary tubular cells. Median estimated duration of warm ischaemia in these kidneys was 25 minutes but one NHBD kidney with an

Discussion

Attempts at resuscitation in patients who subsequently become NHBD, or cardiac massage and ventilation after death, may result in renal ischaemia/reperfusion. Tubular cell death by apoptosis might therefore be anticipated. However, the nuclear changes in apoptosis are the result of enzyme activity and therefore energy-dependent. Cold perfusion and storage may slow the rate of enzyme activity and thus prevent detection of damaged cells prior to rewarming at transplantation. The tubular cells of

References (2)

  • A.T. Burns et al.

    Transplantation

    (1998)
  • Y. Gavrielli et al.

    J Cell Biol

    (1992)

Cited by (1)

  • Biopsy of the marginal kidney donor: Correlation of histology with outcome

    2004, Transplantation Proceedings
    Citation Excerpt :

    These metrics could provide a more objective criterion of the organ damage. Some proposed markers include upregulated HLA-DR27 or cell adhesion28 molecules, presence of lipid peroxidation,29,30 quantitation of apoptosis versus necrosis,31–33 upregulation of Bcl-2,34 or endothelin-1 expression.35 Promising correlations have been shown with all of the above.

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