Update on ischemia-reperfusion injury in kidney transplantation: Pathogenesis and treatment

Table 1 Examples of ischemia and reperfusion injury

Affected organ and surgicalprocedures	Example of clinical manifestation
Heart	Acute coronary syndrome
Kidney	Acute kidney injury
Intestine	Intestinal ischemia and reperfusion
Brain	Stroke
Cardiac surgery	Acute heart failure after cardiopulmonary bypass
Thoracic surgery	Acute lung injury
Peripheral vascular surgery	Compartment syndrome of extremity
Major vascular surgery	Acute kidney injury
Solid organ transplantation	Acute graft failure; early graft rejection

Table 2 Anti-complement agents on clinical trials for ischemia-reperfusion-injury

Complementinhibitor	Target	Major mechanism of action
Eculizumab	C5	Inhibit the formation of C5b-9 and C5a
rhC1-INH	C1r, C1s, Plasmin, C3b, Kallikrein, Xia, XIIa, MASP1, MASP2	Regulatory effect on coagulation Inhibition of the alternative pathway Control of the release of bradykinin
sCR1	C3b, C4b	Inactivation of C3 and C5 convertase

rhC1-INH: Recombinant C1 inhibitor; MASP1: Mannan-binding lectin-associated serine protease1; MASP2: Mannan-binding lectin-associated serine protease 2; sCR1: Soluble complement receptor 1.