Hypothesis: Is renal allograft rejection initiated by the response to injury sustained during the transplant process?

Allograft rejection can be caused by numerous factors such as damage to the donor kidney during surgical removal or implantation, injury sustained dur ing the transport process between the donor and recipient, and suboptimal a llograft perfusion during the intra- and post-operative period. In cadaveri c allografts, damage can occur during cold storage, during the transit stag e between donor and recipient, and hemodynamic instability due to the initi al damage that caused its removal from the donor (such as brain death or tr auma). We hypothesize that rejection requires recognition of this injury in addition to recognition of alloantigens. If indeed injury proves to be one factor in acute rejection episodes, then therapeutic efforts can be made t o reduce injury during the transplantation process.