AUTHOR=Ritschl Paul V. , Günther Julia , Hofhansel Lena , Kühl Anja A. , Sattler Arne , Ernst Stefanie , Friedersdorff Frank , Ebner Susanne , Weiss Sascha , Bösmüller Claudia , Weissenbacher Annemarie , Oberhuber Rupert , Cardini Benno , Öllinger Robert , Schneeberger Stefan , Biebl Matthias , Denecke Christian , Margreiter Christian , Resch Thomas , Aigner Felix , Maglione Manuel , Pratschke Johann , Kotsch Katja 

TITLE=Graft Pre-conditioning by Peri-Operative Perfusion of Kidney Allografts With Rabbit Anti-human T-lymphocyte Globulin Results in Improved Kidney Graft Function in the Early Post-transplantation Period—a Prospective, Randomized Placebo-Controlled Trial

JOURNAL=Frontiers in Immunology

VOLUME=9

YEAR=2018

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2018.01911

DOI=10.3389/fimmu.2018.01911

ISSN=1664-3224

ABSTRACT=<p><bold>Introduction:</bold> Although prone to a higher degree of ischemia reperfusion injury (IRI), the use of extended criteria donor (ECD) organs has become reality in transplantation. We therefore postulated that peri-operative perfusion of renal transplants with anti-human T-lymphocyte globulin (ATLG) ameliorates IRI and results in improved graft function.</p><p><bold>Methods:</bold> We performed a randomized, single-blinded, placebo-controlled trial involving 50 kidneys (KTx). Prior to implantation organs were perfused and incubated with ATLG (AP) (<italic>n</italic> = 24 kidney). Control organs (CP) were perfused with saline only (<italic>n</italic> = 26 kidney). Primary endpoint was defined as graft function reflected by serum creatinine at day 7 post transplantation (post-tx).</p><p><bold>Results:</bold> AP-KTx recipients illustrated significantly better graft function at day 7 post-tx as reflected by lower creatinine levels, whereas no treatment effect was observed after 12 months surveillance. During the early hospitalization phase, 16 of the 26 CP-KTx patients required dialysis during the first 7 days post-tx, whereas only 10 of the 24 AP-KTx patients underwent dialysis. No treatment-specific differences were detected for various lymphocytes subsets in the peripheral blood of patients. Additionally, mRNA analysis of 0-h biopsies post incubation with ATLG revealed no changes of intragraft inflammatory expression patterns between AP and CP organs.</p><p><bold>Conclusion:</bold> We here present the first clinical study on peri-operative organ perfusion with ATLG illustrating improved graft function in the early period post kidney transplantation.</p><p><bold>Clinical Trial Registration:</bold><ext-link ext-link-type="uri" xlink:href="http://www.ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">www.ClinicalTrials.gov</ext-link>, NCT03377283</p>