The contribution of adhesion molecule expression in donor kidney biopsies to early allograft dysfunction

Background. Renal allograft rejection is associated with the expression of adhesion molecules on vascular endothelial and tubular epithelial cells. Methods. To assess whether the number of cell adhesion molecules expressed in donor kidneys can predict early rejection or delayed graft function, kid ney biopsies from 20 living and 53 cadaveric kidney donors were obtained be fore engraftment into the recipients and the expression of the cell adhesio n molecules intercellular adhesion molecule 1 (ICAM-1), vascular cell adhes ion molecule 1 (VCAM-1), and endothelial leukocyte adhesion molecule (E-sel ectin) were determined by immunohistochemistry. Results. All biopsies from living donors showed significantly lower express ion of ICAM-1 and VCAM-1 compared to biopsies from cadaveric donors. There was no difference in the expression of adhesion molecules on tubular cells between transplants with primary function compared to allografts with early rejection in living donated kidneys (ICAM-1: 2 +/-8 vs. 3 +/-8%; VCAM-1: 9 +/-7 vs. 1 +/-1%), as well as in cadaveric kidneys (ICAM-1: 38 +/- 29 vs. 39 +/- 38%; VCAM-1: 55 +/- 27 vs. 48 +/- 29%). The expression of ICAM-1 mol ecules on tubular cells was determined to be a predictor for the occurrence of delayed graft function in cadaveric kidneys (ICAM-1: 65 +/- 24* vs. 38 +/- 29% delayed graft versus primary graft function). No delayed graft func tion occurred in recipients of living donated kidneys. Conclusions. These data suggest that adhesion molecule expression in donor biopsies is not a predictor for early allograft rejection, but can be used as a marker for the development of postischemic acute renal allograft failu re.