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BN 52021: A Platelet Activating Factor Antagonist for Preventing Post-Transplant Renal Failure: A Double-Blind, Randomized Study
- From the Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. For The BN 52021 Study Group in Renal Transplantation* *Members of the BN 52021 Study Group in Renal Transplantation are listed in the Appendix. Requests for Reprints: Josep M. Grino, MD, Department of Nephrology, Hospital de Bellvitge, C. Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
Platelet activating factor (a glycerophospholipid) is an inflammatory mediator that plays an important role in allergic and inflammatory processes [1], including ischemic renal failure [2-4]. Ginkgolide BN 52021 is a receptor antagonist for platelet activating factor that exerts a protective effect on renal function in experimental ischemic acute renal failure [5]. Many of the pathophysiologic responses and the microcirculatory failure that result from release of platelet activating factor mimic the responses observed after ischemia and reperfusion injury [6]. For example, selectins, integrins, and platelet activating factor contribute to the adhesion of polymorphonuclear cells to the endothelium [7]. We did a pilot double-blind study assessing the use of BN 52021 to prevent post-transplant renal failure in patients who received clinical renal cadaveric transplantation.
Methods
From August 1991 to December 1992, kidney cadaveric donors were randomly allocated, in blocks of four, to receive BN 52021 (Institut Henri Beaufour, Le Plessis Robinson, France) or placebo. Donors were treated with BN 52021, 240 mg intravenously, or placebo in the surgical room just before kidney harvesting. The kidneys were perfused and stored at 4 °C using BN 52021, 0.08 mg per millilitre of University of Wisconsin solution or using placebo, respectively. Donors and recipients received the same substance (either BN 52021 or placebo). Following the same schedule, recipients receiving their first renal transplants were treated with either BN 52021 or placebo. In the BN …
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