Researchers identify critical window in deceased donors with the potential to assess and improve the health of donated kidneys
A new research study has been published in the American Journal of Transplantation, led by Associate Professor Maria Kaisar and her team at the University of Oxford and NHS Blood and Transplant. The study was funded by the Stoneygate Trust and Garfield Weston Foundation and supported by Kidney Research UK and NHS Blood and Transplant.
The results show the effects of early inflammation in deceased donors and how this impacts the kidneys before transplant. This reveals a crucial window during donor management for new interventions and treatments that could protect donated kidneys.
How does the immune system affect donated kidneys?
Maria and her team have been looking at the activity of the immune system in deceased donors before transplant surgery, to see if this could affect kidney health. By looking at blood samples from deceased donors they found TNF alpha, a marker of inflammation, was higher in some donors before transplant surgery.
They then looked at how well these kidneys performed in the patients who received the transplant. They found that kidneys from donors with high TNF alpha had greater levels of injury to the kidney cells. When they looked at outcomes for the transplant recipients, they found kidneys from donors with higher TNF alpha levels functioned less well long term.
“Through the analysis of a large number of blood samples from the QUOD Biobank we were able to show that early, high levels of inflammation in deceased donors affect kidney health and have a negative impact on transplant outcomes in the recipients of these donated kidneys.
"We hope that new interventions, that could protect donor kidneys and improve outcomes for patients, could be applied at this early crucial period during donor management. We are excited that our study will initiate new research and clinical trials for the purpose of improving donor organ quality so more organs are available to patients waiting for a transplant.” Associate Professor Maria Kaisar.
David Crosby, chief research officer at Kidney Research UK:
“There are around 7,000 people currently waiting for a kidney transplant in the UK. Too many donated kidneys are not transplanted due to concerns about the health of the kidney. We need to find new ways of assessing and protecting donated kidneys, so they function better for longer.
"These results have given us a new understanding of how the immune system is affecting kidney health in deceased donors early, before transplant surgery. This could lead the way for new treatments and interventions to protect donor kidneys during this crucial period.”
Could we protect donor kidneys from the immune system earlier?
Maria and the team added donor blood samples with high levels of TNF alpha to human kidney cells along with infliximab, an inflammation blocking treatment. They found that this drug protected the kidney cells from injury. With further research, this type of treatment could help protect kidney health in deceased donors during events where inflammation has increased before transplant surgery.
What could this mean for kidney patients?
Understanding how inflammation can affect kidney health in deceased donors means new treatments could be developed in the future to help protect the kidneys during this crucial period. This could improve the health of some donated kidneys so transplants last for longer.
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