Genetic, Physiological, and Pharmacological Amelioration of Ischemic Injury
Year: 2010
Type: dissertation
Abstract: Organ transplantation is the treatment of choice for end stage organ failure, and in recent decades\\none year results have greatly improved. Two major problems facing the transplant community\\nremain; long-term survival of organ grafts has still not reached its full potential, and the shortage\\nof suitable donor organs is still increasing.\\nLong-term graft survival is significantly hampered by chronic transplant dysfunction (CTD). This\\nstill poorly defined process of untreatable functional deterioration of an organ following transplantation\\naccounts for approximately 30 percent of graft loss in the first 5 years after transplantation.\\nIn the kidney CTD, also known as chronic allograft nephropathy (CAN), is clinically\\ncharacterized by progressive renal dysfunction, associated with hypertension and proteinuria.\\nRenal biopsies show characteristic but nonspecific histopathological changes in the vascular, glomerular\\nand tubulointerstitial compartments of the kidney, which overlap with the histology of\\nnormally aging kidneys. Although the term CAN has been recently replaced by \\xe2\\x80\\x9cinterstitial fibrosis\\nand tubular atrophy without evidence of any specific etiology\\xe2\\x80\\x9d [3], we continue to use CAN in this\\nthesis, as this is the terminology used in the majority of the literature available to date.\\nIncreasing evidence suggests that the development of CAN is multifactorial in origin, with alloantigen\\ndependent and allo-antigen independent factors contributing to the decline of renal\\ngraft function. Of the allo-antigen independent factors, donor age and cold ischemia time\\nseem to be the major correlate to transplant survival. Clinical observations suggest an inverse\\nrelationship between both donor age and ischemia time and long-term graft survival.\\nThe mechanisms by which donor age or ischemia lead to reduced functional life span are currently\\nunknown.
Author: Denis Susa
Language: English
Subfield: Transplantation
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2129930423