Organ replacement, support and regeneration

Research activities are focused on several areas: replacement and support of the function of vital organs in critical conditions, kidney transplantation, uremic toxicity and biocompatibility of dialysis therapy. Kidney transplantation replaces all renal functions and is currently the best method of treatment of chronic renal failure. The main problem of transplantation is the development of chronic graft dysfunction and subsequent graft failure and therefore we focus, in randomised clinical and molecular biology studies, on the influence of viral infection on graft function in particular and we propose new preventive and pre‑emptive procedures based on our results. The dominant topic of research in the area of compensation for organ function is the biocompatibility of extracorporeal circulation and uremic toxicity. The long‑term goal is to understand the molecular mechanisms responsible for bio‑incompatibility of extracorporeal methods and to identify new toxic substances of peptide and protein nature in acute and chronic renal failure using advanced proteomic methods. Unexplained pathophysiology of sepsis and the lacking causal treatment of sepsis are the starting point of systematic translation (which uses clinically relevant large mammalian biomodels) and clinical research focusing on organ, cellular and molecular mechanisms of sepsis, including the development and evaluation of new therapeutic strategies.

Selected outputs

• Reischig T, Kacer M, Jindra P, Hes O, Lysak D, Bouda M. Randomized trial of valganciclovir versus valacyclovir prophylaxis for prevention of cytomegalovirus in renal transplantation. Clin J Am Soc Nephrol. 2015 Feb 6;10(2):294-304.

• Karvunidis T, Chvojka J, Lysak D, Sykora R, Krouzecky A, Radej J, Novak I, Matejovic M. Septic shock and chemotherapy-induced cytopenia: effects on microcirculation. Intensive Care Med. 2012 Aug;38(8):1336-44.

• Benes J, Chvojka J, Sykora R, Radej J, Krouzecky A, Novak I, Matejovic M. Searching for mechanisms that matter in early septic acute kidney injury: an experimental study. Crit Care. 2011;15(5):R256. doi: 10.1186/cc10517.

• Reischig T, Hribova P, Jindra P, Hes O, Bouda M, Treska V, Viklicky O. Long-term outcomes of pre-emptive valganciclovir compared with valacyclovir prophylaxis for prevention of cytomegalovirus in renal transplantation. J Am Soc Nephrol. 2012 Sep;23(9):1588-97.

• Swol J, Belohlávek J, Haft JW, Ichiba S, Lorusso R, Peek GJ. Conditions and procedures for in-hospital extracorporeal life support (ECLS) in cardiopulmonary resuscitation (CPR) of adult patients. Perfusion. 2015 Jun 16. pii: 0267659115591622.

• Belohlavek J, Skalicka H, Boucek T, Kovarnik T, Fichtl J, Smid O, Huptych M, Linhart A. Feasibility of cerebral blood flow and oxygenation monitoring by continuous transcranial Doppler combined with cerebral oximetry in a patient with refractory cardiac arrest treated by extracorporeal life support. Perfusion. 2014 Nov;29(6):534-8. doi: 10.1177/0267659114529322

• Havranek S, Belohlavek J, Mlcek M, Huptych M, Boucek T, Svoboda T, Fichtl J, Hrachovina M, Linhart A, Kittnar O. Median frequencies of prolonged ventricular fibrillation treated by V-A ECMO correspond to a return of spontaneous circulation rate. Int J Artif Organs. 2014 Jan;37(1):48-57. doi: 10.5301/ijao.5000291.

• Belohlavek J, Springer D, Mlcek M, Huptych M, Boucek T, Hodkova G, Fichtl J, Mrazek V, Zima T, Linhart A, Kittnar O. Early vancomycin, amikacin and gentamicin concentrations in pulmonary artery and pulmonary tissue are not affected by VA ECMO (venoarterial extracorporeal membrane oxygenation) in a pig model of prolonged cardiac arrest. Pulm Pharmacol Ther. 2013 Dec;26(6):655-60.

• Belohlavek J, Mlcek M, Huptych M, Svoboda T, Havranek S, Ostadal P, Boucek T, Kovarnik T, Mlejnsky F, Mrazek V, Belohlavek M, Aschermann M, Linhart A, Kittnar O. Coronary versus carotid blood flow and coronary perfusion pressure in a pig model of prolonged cardiac arrest treated by different modes of venoarterial ECMO and intraaortic balloon counterpulsation. Crit Care. 2012 Dec 12;16(2):R50. doi: 10.1186/cc11254.

• Matejovic M, Ince C, Chawla LS, Blantz R, Molitoris BA, Rosner MH, Okusa MD, Kellum JA, Ronco C; ADQI XIII Work Group. Renal Hemodynamics in AKI: In Search of New Treatment Targets. J Am Soc Nephrol. 2015 Oct 28. pii: ASN.2015030234