The Role of the B2 Microglobulin Trend in Patients with Delayed Graft Function After Kidney Transplant
Surgery, University of Chicago, Chicago, IL
Meeting: 2021 American Transplant Congress
Abstract number: 664
Keywords: Graft function, Kidney transplantation, Monitoring, N/A
Topic: Clinical Science » Biomarkers, Immune Assessment and Clinical Outcomes
Session Information
Session Name: Biomarkers, Immune Assessment and Clinical Outcomes
Session Type: Poster Abstract
Session Date & Time: None. Available on demand.
Location: Virtual
*Purpose: Delayed graft function (DGF) is associated with worse short and long-term outcomes after kidney transplantation. There is a lack of biomarkers to predict outcomes in patients with DGF. Serum β2 microglobulin is a low-molecular-weight protein. It strongly correlates with serum cystatin C and creatinine; with the advantage of measuring residual renal in dialysis patients. In kidney transplant patients predicts cardiovascular events, overall mortality and graft failure. The role of the β2 microglobulin trend in patients with DGF has not been explored.
*Methods: This is a retrospective study of all kidney transplants from deceased donors at our institution from 2014 to 2017. Pediatric and multiple organ transplants were excluded. Only patients with serum levels of β2 microglobulin (postoperative day 1 to 5) were included. β2 microglobulin trend was defined as the difference between β2 on postoperative day four and β2 on postoperative day one. We used univariate and multivariate logistic regression models with level of significance of α=0.05.
*Results: A total of 150 kidney recipients were reviewed, 68 (45%) had delayed graft function (median 7.5 days, 1 – 51); 50% of the patients with DGF received dialysis for one week only. Three patients had primary non function. The demographic and clinical characteristics of the patients with and without DGF are shown in tables 1 and 2. β2 microglobulin strongly correlated with the presence of DGF (p<0.001) and significantly correlated with eGFR at 1, 6 and 12 months in all patients (p<0.05). In DGF group, β2 microglobulin trend correlated with the duration of DGF with p=0.05 (95% CI 0.004 - 6.66). This was independent of donors after circulatory death and type of kidney storage. In our cohort, β2 microglobulin was not associated with mortality or rejection.
*Conclusions: The β2 microglobulin trend is a marker of kidney function useful particularly in patients with DGF, because measures the residual kidney function in the setting of dialysis. Following the trend of β2 microglobulin in patients with DGF is informative about the duration of the DGF and may help to make clinical decisions. Validation of this marker in a larger population of patients with DGF is needed.
| Without DGF, N=82 | With DGF, N=68 | |
| Age (median) | 52.7 | 53.1 |
| Male | 61% | 68% |
| African American | 72% | 74% |
| BMI (median) | 27.5 | 27.6 |
| Cause of kidney failure – HTN | 37% | 24% |
| Cause of kidney failure – DM2 | 23% | 21% |
| Time on dialysis, years | 6.4 +/- 3.6 | 7 +/- 2.8 |
| Without DGF, N=82 | With DGF, N=68 | |
| KDPI | 49 +/- 23 | 63 +/- 21 |
| DCD Donor | 30% | 50% |
| Pump | 29% | 41% |
| Warm ischemia (min) | 41 | 42.5 |
| Cold ischemia (hours) | 13.1 | 14.6 |
| Rejection | 17% | 13% |
| Death | 9% | 18% |
To cite this abstract in AMA style:
Perez-Gutierrez A, Bachul PJ, Juengel B, Witkowski P, DiSabato D, Barth R, Fung J, Becker Y. The Role of the B2 Microglobulin Trend in Patients with Delayed Graft Function After Kidney Transplant [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/the-role-of-the-b2-microglobulin-trend-in-patients-with-delayed-graft-function-after-kidney-transplant/. Accessed November 22, 2024.« Back to 2021 American Transplant Congress