@article{c764769cd4774c8089f916367cf8780a,
title = "Insulin-like growth factor-I attenuates delayed graft function in a canine renal autotransplantation model",
abstract = "Background. Insulin-like growth factor-I (IGF-I) has been shown to accelerate recovery in animal models of ischemic or toxic acute renal injury. Ischemic renal injury is frequently encountered after cadaveric transplantation manifested as delayed graft function. This study was performed to determine whether perfusion of kidneys with preservation solution supplemented with IGF-I would improve the course of renal injury in a canine autotransplantation model of delayed graft function. Methods. Dogs underwent unilateral nephrectomy with kidneys perfused and stored in Euro-Collins solution supplemented with vehicle (n = 11) or IGF-I (n = 8). After 24 hours of kidney preservation, a contralateral nephrectomy was performed and the stored kidney was autotransplanted. Renal function was examined for 5 days after the transplantation, and an inulin clearance was obtained at the time of death. Results. Compared with dogs that received kidneys preserved in the vehicle, dogs receiving the IGF-I preserved kidneys had significantly lower daily serum creatinine and blood urea nitrogen levels during the course of 5 days after transplantation. Inulin clearance at death was nearly double in the IGF-I treated animals compared with the vehicle-treated controls (1.37 ± 0.16 ml/min/kg versus 0.77 ± 0.13 ml/min/kg; p < 0.05). Conclusions. Perfusion and storage of kidneys with preservation solution supplemented with IGF-I can attenuate the course of delayed graft function in a canine renal autotransplantation model. IGF-I may have potential for use in cadaveric human renal transplantation.",
author = "D. Petrinec and Reilly, {J. M.} and Sicard, {G. A.} and Lowell, {J. A.} and Howard, {T. K.} and Martin, {D. R.} and Brennan, {D. C.} and Miller, {S. B.}",
note = "Funding Information: POLYPEPTIDE GROWTH FA(~ORS regulate kidney development, growth, and function and participate in processes of repair after renal injury, l' 2 Recently the use of one of these factors, insulin-like growth factor-I (IGF-I), has been shown to accelerate recovery from acute ischemic kidney failure when administered at the time of injury, 24 hours after the injury, when kidney failure is {"}established,{"} or before injury in a prophylactic manner. 3' 4 The mechanisms by which IGF-I acts in acute kidney failure include stimulation of anabolism, the maintenance ofgiomerular filtration, and the enhancement of tubular regeneration. 5 An acute renal injury is frequently encountered in the setting of kidney procure- Supported in part by a grant from the MissouriK idneyP rogram. S.B.M. is supported by a Clinician-ScientistA ward from the American Heart Association. Presented at the Fifty-seventhA nnual Meeting of the Society of University Surgeons, Washington, D.C., Feb. 8-10, 1996. Reprint requests: Steven B. Miller, MD, Washington UniversityS chool of Medicine, 660 S. Euclid Avenue, Box 8126, St. Louis, MO 63110. Copyright 9 1996 by Mosby-Year Book, Inc. 0039-6060/96/$5.00 + 0 11/6/73849 ment, storage, and revascularization for cadaveric transplantation. In fact, approximately 30% of all recipients of cadaveric renal allografts suffer from acute injury severe enough to require dialysis after transplantation. 6 This condition is referred to as delayed graft function and is a major complication of cadaveric transplantation. Patients suffering delayed graft function have longer and more expensive hospitalization, an increased incidence of rejection, and a significantly lower 1-year graft survival rate. 7 Because of the potential use of IGF-I as a pharmacologic agent to treat acute renal injury, we carried out studies to determine whether IGF-I might ameliorate the course of delayed graft function in a canine renal autotransplantation model. The data show that perfusion and cold storage of kidneys in preservation solution supplemented with IGF-I hasten the recovery of renal function and ameliorate the course of delayed graft function. Our findings establish the potential for the use of IGF-I as a therapeutic agent for the prevention of delayed graft function in human cadaveric renal transplantation.",
year = "1996",
doi = "10.1016/S0039-6060(96)80291-1",
language = "English",
volume = "120",
pages = "221--226",
journal = "Surgery",
issn = "0039-6060",
number = "2",
}