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Enhanced Contrast MRI for the Prevention of Renal Graft Rejection

DialysisTransplantation of an organ from a donor who differs genetically from the recipient induces an immune response that, if not controlled, may compromise the graft outcome. Chronic rejection is a major complication in renal transplantation and is currently the most prevalent cause of renal transplant failure.

Current research is focused on developing new noninvasive imaging approaches for the detection of renal graft rejection, as an early identification of damage is thought to be crucial to allow prompt and effective intervention.

In one of their latest articles, researchers from the University of Edinburgh developed a mouse model of renal transplant damage. After the organ transplant, mice suffered from chronic graft damage characterized by interstitial fibrosis, a condition defined by the infiltration of macrophages and monocytes in the transplanted tissue.

Since immune cells, especially macrophages, have been identified as key players in both the fibrotic cascade and inflammation progression, the team investigated whether enhanced contrast MRI would detect the accumulation of these cells. Ultrasmall, supermagnetic particles of iron oxide (USPO), a compound readily taken up by the macrophages and therefore allows for their detection, was chosen as the contrast medium.

From MRI scans, Analyze software was used to segment regions of interest in the kidneys and to calculate R* values, which indicated the degree of USPO uptake. The results showed that the contrast medium signal was significantly higher in the transplanted kidneys than in the native ones, suggesting that the transplanted organs underwent a significant infiltration of macrophages.

This study indicated that USPO-enhanced MRI might be efficiently used in the detection and monitoring of chronic inflammatory damage after renal transplant. This noninvasive imaging approach is a powerful alternative to renal biopsy, and offers the possibility of forestalling graft rejection and reducing the number of biopsies required to measure the development of graft injury.

Related: Plasma Copeptin Levels: a Biomarker of Renal Function

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