Ischemia Reperfusion Injury in Human Kidney-Pancreas Transplantation: Protection By α-Lipoc Acid Require the Treatment of Both The Donor and The Recipient.

Abstract

α-lipoic acid (ALA) is a potent antioxidant and is approved for treatment of diabetic sensorimotor polyneuropathy in some countries. Patients that received kidney-pancreas transplantation in order to ameliorate polyneuropathy, may be treated with ALA. We have previously observed that the administration of ALA to donors and recipients protects from IRI, by decreasing serum IL-8 and postoperative amylase and lipase values in blood. The aim of the present work was to determine if the administration of ALA only to the recipient would protect from IRI. The study included 24 kidney-pancreas transplant patients. They were divided in three groups: G1: without ALA treatment; G2: ALA (600 mg) was administered to the deceased donor at the time of ablation and, to the recipients during the surgical procedure; G3: ALA (600 mg) was administered only to the recipients immediately previous to the surgical procedure. Blood samples were obtained at the beginning of the surgery; at the end of surgery and after the unclamping procedure; 12 h after surgery; and every one or two day after the transplant. Human inflammatory cytokines (TNF-α, IL-1β, IL-10, IL-8, IL-6 and IL-12p79) and SLPI were measured by Cytometric Bead Array and sandwich ELISA, respectively. The measurements of serum amylase, lipase, glycemia and creatinine levels were performed as markers of organ rejection for at least 10 days post-surgery. An increased in IL-8 (p<0.01) and a decreased in SLPI was observed immediately after the surgery in group 1 (p=0.006) and group 3 (p=0.024). However, in group 2 we observed an increased in SLPI (p=0.009), while there was a mild but not statistically significant increased in IL-8. The analysis of measurement of serum lipase and amylase showed that the mean values of the group 2 were lower than group 1 and 3 (P < 0.001). Overall, these results demonstrate that lipoic acid is capable of reducing ischemia reperfusion injury in simultaneous kidney pancreas transplantation, as long as donor and recipient are treated with the drug. DISCLOSURES:Incardona, C.: Employee, GADOR.