Scientists identify why some kidney transplants don't work

Scientists have discovered a Œmolecular 'signature' for the allostatic load - or 'Œwear and tear' of kidneys ­ which could help clinicians understand why some kidney transplants don't work as well as expected.
The University of Glasgow-led research, based on a first-of-its-kind study, can now explain why allostatic load develops at a molecular and cellular level, how it affects physiological function and the role of age-related organ capability and resilience. Allostatic load is the Œwear and tear on the body that accumulates as an individual is exposed to repeated or chronic stress. It reflects the Œburden of lifestyle and life events.
In the study, the scientists, in collaboration with NHS Great Glasgow & Clyde surgeons and pharmaceutical company GlaxoSmithKline, studied transplanted kidneys which developed Delayed Graft Function (DGF). DGF is when the organ fails to work after transplantation, and the patient has to be dialysed until the organ starts working or is lost. The kidneys which displayed impaired function, or DGF, appear to be predisposed to exhibit a greater response to transplant stress and take longer to resolve this.
Previously, the scientists demonstrated that the biological age of transplanted kidneys was important for how well a kidney worked following transplantation, but it was not known why DGF, and the resulting impaired kidney function, occurred. The scientists now demonstrate that at a molecular level, the kidneys studied displayed a greater magnitude of change in key genes, and elevated expression of features of ageing, consistent with increased allostatic load, or wear and tear.
Paul Shiels, Professor of Geroscience at the University's Institute of Cancer Sciences, said: "We now have strong evidence that an organ's biological age, in combination with physiological stress, plays a major role in DGF, or impaired function, occurring. The findings also suggest that these effects are driven by donor characteristics, which may be more of a factor than transplant stress itself.
"Our findings are important because, not only have we identified the reason why some kidney transplants don¹t work when transplanted, we also demonstrate that miles on the biological clock affect the physiological function of organs. This isn¹t just clinically important, but is also relevant to how we age and how we can maintain good health in old age."

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