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Immune response associated with ischemia and reperfusion injury during organ transplantation. Inflamm Res 2022; 71:1463-1476. [PMID: 36282292 PMCID: PMC9653341 DOI: 10.1007/s00011-022-01651-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 12/03/2022] Open
Abstract
Background Ischemia and reperfusion injury (IRI) is an ineluctable immune-related pathophysiological process during organ transplantation, which not only causes a shortage of donor organs, but also has long-term and short-term negative consequences on patients. Severe IRI-induced cell death leads to the release of endogenous substances, which bind specifically to receptors on immune cells to initiate an immune response. Although innate and adaptive immunity have been discovered to play essential roles in IRI in the context of organ transplantation, the pathway and precise involvement of the immune response at various stages has not yet to be elucidated. Methods We combined “IRI” and “organ transplantation” with keywords, respectively such as immune cells, danger signal molecules, macrophages, neutrophils, natural killer cells, complement cascade, T cells or B cells in PubMed and the Web of Science to search for relevant literatures. Conclusion Comprehension of the immune mechanisms involved in organ transplantation is promising for the treatment of IRI, this review summarizes the similarities and differences in both innate and adaptive immunity and advancements in the immune response associated with IRI during diverse organ transplantation.
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Fujino Y, Kamoda Y, Tanioka Y, Sakai T, Kuroda Y. Prevention of intimal hyperplasia employing the cavitary two-layer method in allogeneic rat heart transplantation. J Surg Res 2011; 176:275-80. [PMID: 21840018 DOI: 10.1016/j.jss.2011.06.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 06/21/2011] [Accepted: 06/22/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND The development of graft arteriosclerosis is a significant contributor to chronic rejection in organ transplant recipients. The purpose of the present study was to establish whether or not the cavitary two-layer method can prevent graft arteriosclerosis after rat heart transplantation. METHODS F-344 rats served as donors to Lewis recipients. Grafts in the control group (group C) were immediately allotransplanted without preservation. Grafts were also transplanted after cold preservation for 3 h in University of Wisconsin solution (group UW), or employing the cavitary two-layer (CTL) method (group TL). In another group (group W), grafts were subjected to 15-min warm ischemia and then transplanted. Grafts damaged by ischemia were also transplanted after preservation for 3 h using CTL (group WTL). We measured intimal thickening (IT) before transplantation and at 30 and 60 d post-transplant and also assessed the expression of heat shock proteins (HSPs). RESULTS At 60 d post-transplant, IT in group WTL was significantly lower than in group W (0.30 ± 0.03 versus 0.45 ± 0.04, respectively). In contrast, no significant changes were observed in the cold storage groups. Expression of HSPs 60 and 70 at 60 d in group WTL (25.40% ± 1.64% and 35.96% ± 2.65%, respectively) was reduced compared with group W (46.07% ± 5.84% and 55.11% ± 1.54%, respectively). CONCLUSIONS CTL reduces IT induced by warm ischemia in rat heart transplantation, and allows the maintenance of low HSP 60 and 70 expression.
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Abstract
The two-layer cold storage method (TLM) was first reported in 1988, consisting of a perfluorochemical (PFC) and initially Euro-Collins’ solution, which was later replaced by University of Wisconsin solution (UW). PFC is a biologically inert liquid and acts as an oxygen-supplying agent. A pancreas preserved using the TLM is oxygenated through the PFC and substrates are supplied by the UW solution. This allows the pancreas preserved using the TLM to generate adenosine triphosphate during storage, prolonging the preservation time. In a canine model, the TLM was shown to repair and resuscitate warm ischemically damaged pancreata during preservation, improve pancreas graft survival after transplantation, and also improve the islet yield after isolation. Clinical trials using the TLM in pancreas preservation before whole-pancreas transplantation and islet isolation have shown promising outcomes. We describe the role of the TLM in pancreas and islet transplantation.
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Noguchi H, Levy MF, Kobayashi N, Matsumoto S. Pancreas preservation by the two-layer method: does it have a beneficial effect compared with simple preservation in University of Wisconsin solution? Cell Transplant 2009; 18:497-503. [PMID: 19775509 DOI: 10.1177/096368970901805-603] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
A large number of reports have shown that the two-layer method (TLM), which employs oxygenated perfluorochemical (PFC) and University of Wisconsin (UW) solution, is superior to simple cold storage in UW in islet transplantation. However, two recent large-scale studies showed no beneficial effect of TLM compared with UW storage in human islet transplantation. We reevaluated the effect of TLM by following three groups: group 1: UW simple storage; group 2: TLM performed by multiorgan procurement teams (not specialists of islet isolation); and group 3: TLM performed by specialists of islet isolation (Noguchi and Matsumoto). There were no significant differences between groups 1 and 2, whereas islet yields were significantly higher in group 3 compared with either group 1 or 2. Our data suggest that exact, complete performance of TLM could improve the outcome of islet isolation and transplantation. In this review, we describe the mechanisms of the TLM, the procedure of preoxygenated TLM, and the several possibilities for the reasons of the discrepancy.
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Affiliation(s)
- Hirofumi Noguchi
- Baylor Institute for Immunology Research/Baylor All Saints Medical Center, Baylor Research Institute, Dallas, TX, USA.
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Agrawal A, Gurusamy K, Powis S, Gray DW, Fuller B, Davidson BR. A Meta-Analysis of the Impact of the Two-Layer Method of Preservation on Human Pancreatic Islet Transplantation. Cell Transplant 2008; 17:1315-22. [DOI: 10.3727/096368908787648065] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
There are conflicting reports about the effectiveness of perfluorocarbons used in the two-layer method (TLM) of pancreas preservation for human islet transplantation. The mechanism of action is unclear and the optimal role of this method uncertain. The study design was a meta-analysis of the evidence that TLM improves islet isolation outcomes. Pubmed, CENTRAL, EMBASE, Science Citation Index, and BIOSIS were searched electronically in January 2008. After selecting the relevant human trials for meta-analysis data relating to donor variables, study design, primary and secondary islet isolation outcomes were extracted. Electronic searches identified eight unique citations, describing 11 human studies that were eligible for the meta-analysis. When comparing TLM with preservation in University of Wisconsin (UW) solution, there was a statistically significant higher islet yield [WMD 711.55, 95% confidence interval (CI) 140.03–1283.07] in the TLM group. The proportion of transplantable preparations obtained was not significantly different (OR 1.30, 95% CI 0.89–1.88) between the two groups. The rate of successful islet isolations for marginal organs was higher in the TLM group (OR 6.69, 95% CI 1.80–24.87). Improved oxygenation and preservation of cellular bioengertics is thought to be the main underlying mechanism, although no single mechanism has yet been confirmed. There is currently no clear evidence that the TLM is beneficial in human islet transplantation. It may improve the preservation of marginal organs.
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Affiliation(s)
- Aditya Agrawal
- Department of HPB and Liver Transplant Surgery, Royal Free Hospital, Royal Free and University College School of Medicine, London NW3 2PF, UK
- Department of Nephrology, Royal Free Hospital, Royal Free and University College School of Medicine, London NW3 2PF, UK
- Nuffield Department of Surgery, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Kurinchi Gurusamy
- Department of HPB and Liver Transplant Surgery, Royal Free Hospital, Royal Free and University College School of Medicine, London NW3 2PF, UK
| | - Steve Powis
- Department of Nephrology, Royal Free Hospital, Royal Free and University College School of Medicine, London NW3 2PF, UK
| | - Derek W. Gray
- Nuffield Department of Surgery, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Barry Fuller
- Department of HPB and Liver Transplant Surgery, Royal Free Hospital, Royal Free and University College School of Medicine, London NW3 2PF, UK
| | - Brian R. Davidson
- Department of HPB and Liver Transplant Surgery, Royal Free Hospital, Royal Free and University College School of Medicine, London NW3 2PF, UK
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Kamoda Y, Fujino Y, Tanioka Y, Sakai T, Kuroda Y. Ischemically damaged heart after preservation by the cavitary two-layer method as a possible donor in rat heart transplantation. J Heart Lung Transplant 2007; 26:1320-5. [PMID: 18096485 DOI: 10.1016/j.healun.2007.07.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2007] [Revised: 07/27/2007] [Accepted: 07/27/2007] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine the possibility of using an ischemically damaged heart, after preservation by the cavitary two-layer (CTL) method, as a donor in heart transplantation. METHODS Each donor heart was heterotopically transplanted to the recipient aorta. The grafts in Group 1 were immediately transplanted. In Group 2, the grafts with (a) 15- or (b) 30-minute warm ischemia were transplanted. The ischemically damaged grafts were transplanted after preservation for 3 hours in University of Wisconsin (UW) solution (Group 3) or CTL (Group 4). Five-day animal survival, tissue adenine triphosphate (ATP) concentration, biochemical assay and histopathologic data were obtained. RESULTS Five-day survival in Group 4a was 7 of 8, with significant recovery of the ATP tissue level (9.31 +/- 0.80 micromol/dry weight). Biochemical and pathologic examinations demonstrated that ischemia-reperfusion injury was prevented in Group 4a compared with Group 2a. CONCLUSIONS An ischemically damaged rat heart preserved for 3 hours by CTL was found to be a potential donor in rat heart transplantation.
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Affiliation(s)
- Yasuhisa Kamoda
- Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Ichii H, Wang X, Messinger S, Alvarez A, Fraker C, Khan A, Kuroda Y, Inverardi L, Goss JA, Alejandro R, Ricordi C. Improved human islet isolation using nicotinamide. Am J Transplant 2006; 6:2060-8. [PMID: 16827790 DOI: 10.1111/j.1600-6143.2006.01452.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We investigated the effects of nicotinamide (NA) supplementation of the processing medium during islet isolation. One hundred and two human pancreata were processed for clinical transplantation after preservation either in the University of Wisconsin (UW) or using the two-layer method (TLM). Pancreata were then divided into four groups and retrospectively analyzed. Group I: UW preservation followed by processing without NA, Group II: UW preservation and processing with NA, Group III: TLM preservation without NA, Group IV: TLM preservation with NA. We observed a significant increase in islet yield in Group II (4343+/-348 IEQ/g) [mean+/-SEM], compared to Group I (2789+/-348 IEQ/g) (p=0.005). Similarly, a significant increase in islet yield was observed when NA was used in the processing of organs preserved with TLM (Group IV: 5538+/-413 vs. Group III: 3500+/-629; p=0.02). Furthermore islet yield was higher in Group IV than in Group II (p<0.05). The percentages of preparations that qualified for transplantation were 25, 47, 45, 69% in Groups I, II, III, IV, respectively. Addition of NA to the processing medium significantly improved islet yields in both the UW and TLM preservation protocols, allowing for a higher percentage of islet preparations to qualify for clinical transplantation.
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Affiliation(s)
- H Ichii
- Diabetes Research Institute, Department of Epidemiology and Public Health, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
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Yuan CH, Li GC, Zhang H, Cheng Y, Zhao N, Liu YF. Evaluation of the viability and energy metabolism of canine pancreas graft subjected to significant warm ischemia damage during preservation by UW solution cold storage method. World J Gastroenterol 2004; 10:1785-8. [PMID: 15188506 PMCID: PMC4572269 DOI: 10.3748/wjg.v10.i12.1785] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM: To evaluate the viability and energy metabolism of long warm ischemically damaged pancreas during preservation by the UW solution cold storage method.
METHODS: The pancreas grafts subjected to 30-120 min warm ischemia were preserved by the UW solution cold storage method for 24 h. The tissue concentrations of adenine nucleotides (AN) and adenosine triphosphate (ATP) and total adenine nucleotides (TAN) were determined by using high performance liquid chromatography (HPLC) and the viability of the pancreas graft was tested in the canine model of segmental pancreas autotransplantation.
RESULTS: The functional success rates of pancreas grafts of groups after 30 min, 60 min, 90 min, 120 min of warm ischemia were 100%, 100%, 67.7%, 0%, respectively. There was an excellent correlation between the posttransplant viability and tissue concentration of ATP and TAN at the end of preservation.
CONCLUSION: The UW solution cold storage method was effective for functional recovery of the pancreas suffering 60-min warm ischemia. The tissue concentration of ATP and TAN at the end of 24 h preservation by the UW solution cold storage method would predict the posttransplant outcome of pancreas graft subjected to significant warm ischemia.
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Affiliation(s)
- Chun-Hui Yuan
- Department of Organ Transplantation, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Provience, China.
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Fujino Y, Kakinoki K, Suzuki Y, Li S, Tanaka T, Tanioka Y, Sakai T, Ku Y, Kuroda Y. Successful 24-hour preservation of ischemically damaged canine small intestine by the cavitary two-layer method. Transplantation 2003; 76:777-80. [PMID: 14501852 DOI: 10.1097/01.tp.0000082526.60737.ae] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The purpose of this study is to examine the possibility of a long-term preservation of the ischemically damaged intestine by the cavitary two-layer method (TLM) in canine small intestinal transplantation. METHODS The grafts were allotransplanted without preservation immediately (group 1) or after 30 minutes of warm ischemia (group 2). The ischemically damaged grafts were also allotransplanted after cold preservation for 24 hours in University of Wisconsin (UW) solution (group 3) or the cavitary TLM (group 4). Seven-day survivals, tissue adenosine triphosphate (ATP) concentrations, absorption tests, and histopathology were examined. RESULTS seven-day survivals in groups 1, 2, 3, and 4 were 8 of 8, 6 of 8, 0 of 8, and 6 of 8, respectively. In group 4, significant recovery of ATP tissue level was seen after preservation compared with group 3, and absorption function and regeneration of the graft mucosa recovered at day 14. CONCLUSIONS Ischemically damaged canine small intestine could be preserved for 24 hours by the cavitary TLM.
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Affiliation(s)
- Yasuhiro Fujino
- Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Japan.
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Fujino Y, Suzuki Y, Kakinoki K, Tanioka Y, Ku Y, Kuroda Y. Protection against experimental small intestinal ischaemia-reperfusion injury with oxygenated perfluorochemical. Br J Surg 2003; 90:1015-20. [PMID: 12905558 DOI: 10.1002/bjs.4138] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Intestinal ischaemia-reperfusion (IR) injury frequently occurs in abdominal surgery. Perfluorochemical (PFC) can be used to oxygenate intestinal organs directly and allows adenosine 5'-triphosphate (ATP) production within the submerged organs during ischaemia. This study was designed to evaluate the protective effect of PFC in IR injury, focusing on cytokine production in rat small intestine. METHODS The superior mesenteric artery was occluded in rats for 60 min and the small bowel placed in an intestinal bag containing either normal saline (group 1), oxygenated saline (group 2) or oxygenated PFC (group 3). The arterial clip was subsequently removed, allowing reperfusion. The number of rats that survived for 7 days, tissue ATP levels, biochemical variables, tissue lipid peroxidation (LPO), bacterial cultures and histological changes were examined after reperfusion. RESULTS The use of oxygenated PFC in group 3 improved survival compared with the other groups. Serum creatine phosphokinase and lactate dehydrogenase levels in groups 1 and 2 reflected small intestinal damage, and plasma levels of tumour necrosis factor alpha and interleukin 6 were raised. In contrast, oxygenated PFC decreased these levels, and reduced LPO, bacterial translocation and augmented apoptosis of the small intestine after reperfusion. CONCLUSION An intestinal bag containing oxygenated PFC showed protective effects during bowel ischaemia.
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Affiliation(s)
- Y Fujino
- Division of Gastroenterological Surgery, Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Japan.
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Ricordi C, Fraker C, Szust J, Al-Abdullah I, Poggioli R, Kirlew T, Khan A, Alejandro R. Improved human islet isolation outcome from marginal donors following addition of oxygenated perfluorocarbon to the cold-storage solution. Transplantation 2003; 75:1524-7. [PMID: 12792508 DOI: 10.1097/01.tp.0000058813.95063.7a] [Citation(s) in RCA: 131] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Last year, from the approximately 6,000 organ donors, only approximately 1,500 pancreata were used for clinical transplantation. Factors that contribute to this poor pancreas use include strict donor selection criteria and the requirement for short cold-ischemia time (CIT). Numerous pancreata have not been used because of long ischemia times postprocurement. Given the oxygen-rich environment of the islets in the native pancreas, it is conceivable that islets are highly susceptible to irreversible damage following prolonged ischemia. The use of continuously oxygenated perfluorohydrocarbons (PFCs), known for their high oxygen-solubility coefficients, in a two-layer culture with standard University of Wisconsin preservation media, has extended the acceptable range CIT, and, furthermore, there has been no evidence of adverse effects from PFCs on the outcome of transplanted cells, whereas they often enhance islet cell function. The purpose of this study was to use the two-layer culture method to improve donor-organ use from marginal donors. Fifteen organs were procured using the two-layer method, and 18 without using it, from donors greater than 50 years of age. Despite nonsignificant differences in age, weight of the donors, weight of the organ and CIT, the PFC group yielded an average of twofold more islet equivalents than those harvested from the control group. As a result, from the control group, only 2 of 18 organs were used for clinical islet transplantation, whereas 8 of 15 were used from the PFC group. To this end, the two-layer method may help clinicians overcome the problem of organ underuse.
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Affiliation(s)
- Camillo Ricordi
- Diabetes Research Institute, University of Miami School of Medicine, Florida 33136, USA.
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