Renoprotektive Effekte der Zelltherapie mit Progenitorzellen beim renalen Ischämie-Reperfusionsschaden: Die Notwendigkeit der Dekompressionstherapie

Abstract

Purpose: Cell therapy represents a promising therapeutic approach in kidney transplantation. This study examines the precise potentials and limits of cell therapy in renal ischemia-reperfusion injury. Methods: The effects of endothelial progenitor cell therapy following a 45 min warm ischemia were investigated in a murine model of renal ischemia-reperfusion injury alone and in combination with surgical decompression of the renal compartment. Renal function was measured by ^99mTc-MAG3 scintigraphy and laser Doppler perfusion. Structural damage was assessed by histological/ immunohistochemical analysis. Results: Warm ischemia of 45 min was associated with severe tissue damage and led to a significant decrease in tubular excretion rate (46.4 % ± 12.5 %, p < 0.05) and renal perfusion (67.7 % ± 3.9 %, p < 0.001). Cell therapy potently enhanced vascular regeneration with increased perfusion (112.5 % ± 3.1 %, p < 0.001) and excellent tissue vitality, while tubular excretion remained impaired (33.3 % ± 8.8 %, p < 0.001). Most importantly, combination of cell-based and decompression therapy enabled significant recovery of renal function (103.3 % ± 16.0 %, p < 0.05) and perfusion (116.7 % ± 2.5 %; p < 0.001) and preserved the integrity of renal structures. Conclusion: Progenitor cell therapy alone promotes vascular regeneration and preserves organ integrity following renal ischemia-reperfusion injury, but lacks beneficial effects on renal function. Combining cellular and decompressive therapy results in enhanced functional recovery and may improve the outcome of renal allografts.