Chronic rejection of the transplanted kidney
Organ transplantation and dialysis are the only effective ways of renal replacement therapy. Because of better quality and extended life expectancy of patients, transplantation is the preferred method of the end stage renal disease treatment. Many mediators are involved in rejection of the transplanted organ. The inflammatory process after organ transplantation is secondary to the ischemia and reperfusion. Cytokines and reactive oxygen species released during reperfusion can increase the expression of ICAM-1 adhesion molecules on the surface of endothelium. Cytokines stimulate also the leukocytes, which leads to increased expression of LFA-1 and VLA-4 on their surface. LFA-1 and VLA-4 molecules react with ICAM-1 and VCAM-1, present on the endothelial cells. Activated due to adhesion leukocytes secrete proteolytic enzymes and reactive oxygen species damaging the endothelium. Read full text »
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