The complement system is one of the crucial pathophysiological mechanisms that directly influence the function of a transplanted kidney. Since the complement pathways' activation potential can be easily determined via their functional activity measurement, we focused on fluctuation in the cascade activity in the early post-transplant period. The aim of the study was to relate the kidney transplantation-induced complement system response to allograft outcome. Forty-two kidney recipients (aged: 53.5 [37-52], 17 females/25 males) and 24 healthy controls (aged: 40.5 [34-51], 13 females/11 males) were enrolled in the study. The functional activities of alternative, classical, and lectin pathways were determined before and in the first week after transplantation using Wielisa®-kit. We observed that the baseline functional activity of the alternative pathway (AP) was higher in chronic kidney disease patients awaiting transplantation compared to healthy controls and that its level depended on the type of dialysis. AP-functional activity was decreased following transplantation procedure and its post-transplant level was related to allograft function. The baseline and transplantation-induced functional activities of the classical and lectin pathways were not influenced by dialysis type and were not associated with transplant outcome. Moreover, our study showed that intraoperative graft surface cooling had a protective effect on AP activation. Our study confirms the influence of dialysis modality on persistent AP complement activation and supports the role of AP in an early phase after kidney transplantation and allograft outcome.

中文翻译：

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移植后替代补体途径激活影响肾脏同种异体移植功能。

补体系统是直接影响移植肾功能的关键病理生理机制之一。由于补体途径的激活潜能可以通过其功能活性测定容易地确定，因此我们着重研究了移植后早期级联活性的波动。该研究的目的是将肾脏移植诱导的补体系统反应与同种异体移植结果联系起来。这项研究共纳入了42位肾脏接受者（年龄：53.5 [37-52]，女性17位/ 25岁男性）和24位健康对照（年龄：40.5 [34-51]，女性13位，男性11位）。使用Wielisa®-kit在移植之前和之后的第一周确定替代途径，经典途径和凝集素途径的功能活性。我们观察到，与健康对照组相比，正在等待移植的慢性肾脏病患者的替代途径（AP）的基线功能活性更高，并且其水平取决于透析的类型。移植后AP功能活性降低，其移植后水平与同种异体移植功能有关。经典和凝集素途径的基线和移植诱导的功能活性不受透析类型的影响，并且与移植结果无关。此外，我们的研究表明术中移植物表面冷却对AP活化具有保护作用。