Proteins in Preservation Fluid Predict Delayed Graft Function of Kidneys from Donors After Circulatory Death.

B. van Balkom,¹ H. Gremmels,¹ L. Ooms,⁴ R. Toorop,² F. Dor,⁵ O. de Jong,¹ L. Michielsen,¹ G. de Borst,² W. de Jager,³ A. van Zuilen,¹ M. Verhaar.¹

¹Nephrology and Hypertension, UMC Utrecht, Utrecht, Netherlands
²Vascular Surgery, UMC Utrecht, Utrecht, Netherlands
³Laboratory of Translational Immunology, UMC Utrecht, Utrecht, Netherlands
⁴Surgery, Erasmus MC, Rotterdam, Netherlands
⁵Renal and Transplant Services, Imperial College Healthcare NHS Trust, London, United Kingdom

Meeting: 2017 American Transplant Congress

Abstract number: D52

Keywords: Donors, Kidney transplantation, non-heart-beating, Preservation

Session Information

Session Name: Poster Session D: Ischemic Injury and Organ Preservation Session III

Session Type: Poster Session

Date: Tuesday, May 2, 2017

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall D1

Background and objectives

Kidney transplantation is the preferred treatment for end-stage kidney disease, and donor kidney shortage urges proper donor-recipient matching. Zero-hour biopsies provide predictive value for short- and long-term transplantation outcome, but are invasive and may not reflect the entire organ. Alternative, more representative methods to predict transplantation outcome are required. We hypothesized that proteins that accumulate in preservation fluid during cold ischemic storage can serve as biomarkers to predict post-transplantation graft function.

Study design, setting, participants and measurements

Levels of 158 proteins were measured in preservation fluids from kidneys donated after circulatory death (DCD, Maastricht category III) collected in two Dutch centers (UMC Utrecht and Erasmus MC Rotterdam) between 2013 and 2015. Five candidate biomarkers identified in a discovery set of 8 kidneys with immediate function (IF) vs 8 with delayed graft function (DGF) were subsequently analyzed in a verification set of 40 additional preservation fluids to establish a prediction model.

Results

Variables tested for their contribution to a prediction model included five proteins and two clinical parameters that distinguished between IF and DGF groups in the discovery set. Stepwise multivariable logistic regression provided a prediction model based on leptin and GM-CSF levels. ROC analysis showed an AUC of 0.869, and addition of recipient BMI, generated a model with an AUC of 0.886.

Conclusions

We demonstrate that donor kidney preservation fluid harbours biomarkers predicting short-term post-transplantation kidney function. Our approach is safe, easy, and performs better than existing prediction algorithms based on clinical parameters.

CITATION INFORMATION: van Balkom B, Gremmels H, Ooms L, Toorop R, Dor F, de Jong O, Michielsen L, de Borst G, de Jager W, van Zuilen A, Verhaar M. Proteins in Preservation Fluid Predict Delayed Graft Function of Kidneys from Donors After Circulatory Death. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Balkom Bvan, Gremmels H, Ooms L, Toorop R, Dor F, Jong Ode, Michielsen L, Borst Gde, Jager Wde, Zuilen Avan, Verhaar M. Proteins in Preservation Fluid Predict Delayed Graft Function of Kidneys from Donors After Circulatory Death. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/proteins-in-preservation-fluid-predict-delayed-graft-function-of-kidneys-from-donors-after-circulatory-death/. Accessed November 22, 2024.

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