Oxidative Stress Status in Renal Transplant Recipients MaryamZahmatkesh, 1 MehriKadkhodaee, 1 MitraMahdavi-Mazdeh, 2 RanaGhaznavi, 1 MohamadHemati, 1 BehjatSeifi, 1 FereshtehGolab, 1 KeyvanHasani, 1 MahbobLessan-Pezeshki, 2 BehzadEinollahi 3 Abstract Objectives: Despite the demonstration of oxidative stress in patients with end-stage renal disease, the oxidative status during and after a renal transplant are not completely understood. Hepatocyte growth factor is reported to act as an endogenous factor against oxidative stress. The aim of this study was to evaluate the pattern of changes in plasma oxidative status and hepatocyte growth factor levels in living-donor renal transplant recipients during the early phase after transplant. Materials and Methods: Nineteen patients who underwent a renal transplant were included. All were on cyclosporine-based immunosuppression. Plasma levels of malondialdehyde, ferric reducing activity, hepatocyte growth factor, vitamin E, erythrocyte glutathione, and superoxide dismutase activities were determined before, and on the second, seventh, and 12 th days after the transplant. Results: High malondialdehyde concentration and low superoxide dismutase activity were seen before and 48 hours after transplant compared with healthy subjects. Significant reductions in plasma ferric reducing activity, malondialdehyde, and hepatocyte growth factor were seen on the seventh and twelfth days after transplant, compared with the before-transplant data. Direct correlations were found between hepatocyte growth factor levels and ferric reducing activity of plasma as well as hepatocyte growth factor and creatinine or uric acid. Conclusions: Renal transplant recipients display persistent oxidative stress during the early phase of transplant. The pattern of oxidative changes should be considered for appropriate time, dosage, type, and the duration of antioxidant therapy in these patients. Key words: Kidney,Reactiveoxygenspecies,Hepatocyte growthfactor,Living-donor. Ischemia-reperfusion accompanied during renal transplant induces oxidative stress (1). Although there are improvements in metabolic disturbances after a renal transplant, but the oxidative status during and after transplant is not completely understood (2). Previous studies have reported the measurementsofserumantioxidantlevelsfollowing transplant. Some studies demonstrated increased activitiesofenzymaticantioxidants(2,3),whileother studies reported a decrease in enzymatic and nonenzymatic antioxidant defense mechanisms (4- 6).Insomecases,antioxidantactivitiesdidnotshow any alteration (7). Because these studies used different experimental conditions, it is plausible that these varying experimental conditions were responsiblefortheinconsistentresults.Itshouldalso be noted that measurement of the total antioxidant capacityinbiologicalsampleswouldallowdetection of the contribution of still unknown antioxidants, and the synergism between antioxidants (8-10). Understanding the pattern of oxidative changes after transplant will lead to clinical strategies to combat oxidative injuries. Therefore, in this study, thepatternofchangesinplasmaoxidativestatuswas evaluated by measurement of erythrocyte glutathione (reduced glutathione), superoxide dismutase activity, plasma malondialdehyde, ferric Copyright © Başkent University 2010 Printed in Turkey. All Rights Reserved. Fromthe 1 DepartmentofPhysiology,SchoolofMedicine,TehranUniversityofMedicalSciences, the 2 Department of Nephrology, Imam Khomeini Hospital, and the 3 Baghiatallah Hospital, Tehran,Iran Acknowledgments: ThisstudywassupportedbyagrantfromTehranUniversityofMedical SciencesandHealthServices. Address reprint requests to: Maryam Zahmatkesh, Department of Physiology, School of Medicine,TehranUniversityofMedicalSciences,141556447Tehran,Iran Phone:+982166419484 Fax: +982166419484 E-mail: zahmatkm@tums.ac.ir Experimental and Clinical Transplantation (2010) 1: 38-44 ARTICLE