Reactivation of the kidney
A group led by researcher Emily Thompson from the University of Newcastle, UK, found that a new normothermal perfusion in combination with cell therapy can improve the functions of marginal kidneys – organs that were taken from marginal donors (people over 70 years old, people under 60 with multiple risk factors or people from 60 to 69 years old who have at least one of the following risk factors: diabetes mellitus, hypertension or other cardiovascular disease). After treatment with adult stem cells, donor kidneys demonstrated improved function.
Shortage of donor kidneys
Kidney transplantation is the best treatment for patients with renal insufficiency, but on average, patients wait about three years for a donor organ. Often, kidneys offered for donation are classified as marginal, and they can lead to problems after transplantation, increasing the risk of needing a repeat transplant.
The aim of the Thompson group's research was to find a new way to make marginal kidneys suitable for transplantation. This would give hope to a large number of people on dialysis and shorten the waiting list. The researchers suggested that if the kidney is treated before transplantation, then there will be no need to treat the recipient himself.
Organ restoration
A newly created method of organ preservation – normothermal hardware perfusion – optimizes metabolism, primarily for organ storage and transportation: oxygen-saturated blood is pumped through the organ at body temperature, maintaining its work after removal from the donor's body. The researchers used hardware perfusion for the introduction of therapeutic agents into the organ and treatment at the stage before transplantation to the patient.
Multipotent Adult Progenitor Cells (MAPC) have powerful immunomodulatory properties that may be useful for minimizing ischemic reperfusion damage to the organ.
The researchers placed five pairs of human kidneys (each pair from one donor) in a normothermal perfusion machine for 7 hours. One kidney from each pair was randomly assigned to the MAPC treatment receiving group. To assess the effectiveness of therapy, samples of perfusate, urine and kidney tissue biopsies were taken.
In the kidneys treated with MARC, the researchers observed a number of reactions associated with improved function: activation of anti-inflammatory cytokines and growth factors was observed (in particular, a decrease in the level of interleukin-1ß (IL-1ß), an increase in the activity of interleukin-10 (IL-10) and indolamine dioxygenase (IDO), which improved blood flow to damaged cells and led to an increase in urine production.
The next step, the authors plan to find out whether the changes observed in the organ after ex vivo treatment lead to improved outcomes in patients after transplantation. In case of a positive result, improving the quality of donor kidneys will increase their number for recipients, reduce waiting times and improve patient health indicators.
Article by E.R.Thompson et al. Novel delivery of cellular therapy to reduce ischaemia reperfusion injury in kidney transplantation is published in the American Journal of Transplantation.
Aminat Adzhieva, portal "Eternal Youth" http://vechnayamolodost.ru based on the materials of Newcastle University: New hope for kidney revival for transplant.