Rheumatoid arthritis drug improves kidneys for transplant

Researchers from Famerp, supported by Fapesp, tested anakinra to reduce inflammation in kidneys from deceased donors, enhancing their transplant viability. The study, awarded at the 2025 Latin American Transplant Congress, yielded promising results in pig kidneys. In Brazil, 60% to 70% of patients face post-transplant complications.

A study led by researchers from the Faculdade de Medicina de São José do Rio Preto (Famerp), funded by the Fundação de Amparo à Pesquisa do Estado de São Paulo (Fapesp), investigated the use of anakinra, an Anvisa-approved drug for rheumatoid arthritis, in preserving kidneys from deceased donors. Conducted in partnership with the University Medical Center Groningen in the Netherlands, the research used 24 pig kidneys, divided into three groups: untreated control, hypothermic perfusion with the drug at 4°C, and normothermic perfusion at 37°C.

Results showed a significant reduction in inflammatory cytokine expression, improving the organs' molecular profile without tissue damage. "We significantly reduced the expression of inflammatory cytokines in treated kidneys," reported lead author Ludimila Leite Marzochi. The drug blocked inflammation starting after brain death, worsened by cold storage.

In Brazil, 60% to 70% of recipients of kidneys from deceased donors develop temporary acute renal failure post-transplant, twice the rate in Europe and the US, due to factors like cold ischemia time and preservation conditions. "This means longer hospitalization, more comorbidities, and higher costs for the health system," explained study supervisor Mário Abbud-Filho.

While normothermic perfusion machines are effective, their high cost – about R$15,000 more per organ, raising SUS transplant costs by 50% – limits adoption, with only one center using them routinely. Anakinra offers an accessible alternative for traditional ice storage. Heloísa Cristina Caldas noted: "We know inflammation begins in the donor, right after brain death".

The study won best paper at the Latin American Transplant Congress in October 2025 in Paraguay. Next steps involve testing on discarded human kidneys in Indiana, USA, from 2026, and evaluation in static preservation methods.

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