Graft Growth and Podocyte Dedifferentiation in Donor-Recipient Size Mismatch Kidney Transplants
Müller-Deile J, Braesen JH, Pollheimer M, Ratschek M, Haller H, Pape L, Schiffer M (2017)
Publication Type: Journal article
Publication year: 2017
Journal
Book Volume: 3
Journal Issue: 10
DOI: 10.1097/TXD.0000000000000728
Abstract
BACKGROUND: Kidney transplantation is the treatment choice for patients with end-stage renal diseases. Because of good long-term outcome, pediatric kidney grafts are also accepted for transplantation in adult recipients despite a significant mismatch in body size and age between donor and recipient. These grafts show a remarkable ability of adaptation to the recipient body and increase in size in a very short period, presumably as an adaptation to hyperfiltration. METHODS: We investigated renal graft growth as well as glomerular proliferation and differentiation markers Kiel-67, paired box gene 2 and Wilms tumor protein (WT1) expression in control biopsies from different transplant constellations: infant donor for infant recipient, infant donor for child recipient, infant donor for adult recipient, child donor for child recipient, child donor for adult recipient, and adult donor for an adult recipient. RESULTS: We detected a significant increase in kidney graft size after transplantation in all conditions with a body size mismatch, which was most prominent when an infant donated for a child. Podocyte WT1 expression was comparable in different transplant conditions, whereas a significant increase in WT1 expression could be detected in parietal epithelial cells, when a kidney graft from a child was transplanted into an adult. In kidney grafts that were relatively small for the recipients, we could detect reexpression of podocyte paired box gene 2. Moreover, the proliferation marker Kiel-67 was expressed in glomerular cells in grafts that increased in size after transplantation. CONCLUSIONS: Kidney grafts rapidly adapt to the recipient size after transplantation if they are transplanted in a body size mismatch constellation. The increase in transplant size is accompanied by an upregulation of proliferation and dedifferentiation markers in podocytes. The different examined conditions exclude hormonal factors as the key trigger for this growth so that most likely hyperfiltration is the key trigger inducing the rapid growth response.
Authors with CRIS profile
Additional Organisation(s)
Involved external institutions
Karl-Franzens-Universität Graz
Austria (AT)
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Germany (DE)
Austria (AT)
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Germany (DE)
How to cite
APA:
Müller-Deile, J., Braesen, J.H., Pollheimer, M., Ratschek, M., Haller, H., Pape, L., & Schiffer, M. (2017). Graft Growth and Podocyte Dedifferentiation in Donor-Recipient Size Mismatch Kidney Transplants. Transplantation Direct, 3(10). https://dx.doi.org/10.1097/TXD.0000000000000728
MLA:
Müller-Deile, Janina, et al. "Graft Growth and Podocyte Dedifferentiation in Donor-Recipient Size Mismatch Kidney Transplants." Transplantation Direct 3.10 (2017).
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