Title:Association Between Delayed Graft Function (DGF) Biomarkers and Long-term Outcomes After Living Donor Kidney Transplantation
VOLUME: 13 ISSUE: 4
Author(s):Zahra Sahraei, Mona Mehdizadeh, Jamshid Salamzadeh, Mohsen Nafar and Azadeh Eshraghi*
Affiliation:Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Department of Statistics, Faculty of Mathematical Sciences, Shahid Beheshti University, Evin Tehran, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Kidney Disease Research Center (CKDRC), Shahid Beheshti University of Medical Sciences, Tehran, Department of Clinical Pharmacy, School of Pharmacy, Shohadaye-7 Tir Hospital, Iran University of Medical Sciences, Tehran
Keywords:Delay Graft Function, interleukin 18, urine neutrophil gelatinase-associated lipocalin, kidney transplant, serum
creatinine (SrCr), urine output (UO).
Abstract:Background and Objectives: The association between preoperative Urine Neutrophil
Gelatinase-associated Lipocalin (uNGAL) and interleukin-18 (uIL-18) with poor 1-year allograft function
has been shown in deceased-donor kidney transplant recipients previously, and also these markers
could predict 3-month allograft function. However, it is unknown whether there is an association between
these postoperative biomarkers with important recipient outcomes beyond this time in livedonor
transplants.
Methods: NGAL and IL-18 four and 24 hours were measured in live-donor kidney transplant recipients
after transplantation. The relationships between changes in these markers with clinical outcomes as
well as kidney function were examined at 1 month and 2 years. Moreover, the association between delayed
graft function with clinical outcome and Serum Creatinine (SrCr) was evaluated during this period.
Results: The Mean age for kidney recipients was 23.9 years. Significant interaction was observed between
uNGAL 24 hr (pvalue=0.01) and uIL-18 four and 24 hr after transplantation (pvalue=0.04,
0.03; respectively) with patients’ outcome after 1 month and changes in uNGAL with outcomes after 2
years (pvalue= 0.04).
Conclusion: Changes in urine NGAL postoperative are associated with worst outcomes, 2 years after
kidney transplantation, suggesting its potential role in identifying patients that are at high risk for diminished
allograft function, outcome and survival.