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Ischemia Reperfusion Injury in Human Kidney-Pancreas Transplantation: Protection by α-Lipoc Acid Require the Treatment of Both The Donor and The Recipient
AMBROSI NELLA; GUERRIERI DIEGO; PETRONI JORGELINA; ARROSAGARAY ; UVA PABLO; CHULUYAN EDUARDO; INCARDONA CLAUDIO; CASADEI DOMINGO
Congreso; World Transplant Congress 2014; 2014
Experimental studies indicate that ALA would have a beneficial effect in transplanted patients through a reduction of the inflammatory response. Previously, we have described that the administration of ALA to donor and recipient of patients undergoing simultaneous kidney and pancreas transplantation reduces inflammatory mediators and pancreatic enzymes. The aim of this study was to further evaluate the effect of the administration of ALA in diabetic patients undergoing simultaneous kidney and pancreas transplantation. At this time we evaluated the effect of the administration of ALA only on recipients and we compared the results with those obtained by treating the donor and the recipients. Methods: 27 kidney-pancreas transplant patients were included. The clinical and research activities being reported are consistent with the Principles of the Declaration of Istanbul as outlined in the ?Declaration of Istanbul on Organ Trafficking and Transplant Tourism?. This study was approved by an Institutional Review Board. The administration of ALA (600 mg, iv) was performed on the deceased donor at the time of ablation and recipients during the surgical procedure (DR group), or only on the recipients (R group). Blood samples were obtained at the beginning, the end, 12 h after the surgery and every one or two days after transplant. Serum cytokines were quantified by flow cytometry with a Cytometric Bead Array. The level of amylase, lipase, glucose, urea and creatinine were used as markers of organ function.Serum levels of SLPI (secretory leukocyte proteinase inhibitor) and PAP (pancreatitis associated protein) were measured by ELISA. The expression of inflammatory genes was analyzed by RT-PCR in renal biopsies taken at the end of surgery. Treatment with ALA have a protective effect on simultaneous kidney-pancreas transplant patients since it reduces amylase and lipase and also pro-inflammatory mediators in serum and biopsies. The protective effect is more pronounced when both donor and recipient are treated with ALA.