The aims of this study are:
1. assessment of ischemia injury of kidney retrieved from standard and expanded criteria
deceased donor before transplantation
2. assessment of efficacy of kidney ischemia injury decreasing
3. assessment of influence of kidney ischemia injury decreasing on its function after
transplantation For the purpose of this research one hundred kidney will be retrieved
from deceased donors (standard and expanded criteria deceased donors) for
transplantation. All kidneys before transplantation will be stored in machine perfusion
in hypothermia with continuous flow - Organ Recovery Systems LifePort - each single
kidney in self-contained perfusion system.
For the kidney allograft assessment will be used measurements performed during machine
perfusion in hypothermia: renal flow, resistance, lactate dehydrogenase, lactates and
ischemia injury markers measured in the fourth hour of perfusion in perfusion fluid.
For kidney ischemia injury assessment such markers will be measured: tumour necrosis factor
(TNF alfa), interleukin 2 (IL-2), interleukin 6 (IL-6), high sensitivity C-reactive protein
(hsCRP), platelet-derived growth factor (PDGF), cystatin C, kidney Injury Molecule (KIM-1),
neutrophil Gelatinase-associated Lipocalin (NGAL), complement component C3, caspase 3.
Every time from pair of retrieved kidneys each kidney will be randomise for one of the group:
- group 1) - 50 kidneys - examined group - "cured" with etanercept (ENBREL) in the first
hour of perfusion by adding drug to perfusion fluid,
- group 2) - 50 kidneys - control group - without intervention. Ischemia injury markers
will be measured in perfusion fluid by kidney two times (in the first and fourth hour of
perfusion) for assessment of efficacy kidney ischemia injury decreasing.
Results of measurements of kidney ischemia injury before transplantation, parameters during
machine perfusion in hypothermia and donor parameters will be correlated with kidney
allograft function post transplantation.
Immediate, delayed and slow graft function, primary non-function, kidney function assessed by
creatinine concentration and creatinine clearance at one day, seven days, two weeks, 1, 6 and
12 months post transplantation and kidney graft survival 6 and 12 months post transplantation
will be analysed.