Biomarkers of Deceased Donors for the Prediction of Renal Allograft Outcomes

S. Kang,¹ H. Im,¹ J. Lee,¹ T. Koo,¹ S. Lee,² S. Park,³ S.-J. Kim,⁴ C. Ahn,¹ J. Yang.¹

¹Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea
²Chonbuk National University Hospital, Jeonju, Republic of Korea
³Inje University Busan Paik Hospital, Busan, Republic of Korea
⁴Samsung Medical Center, Seoul, Republic of Korea.

Meeting: 2015 American Transplant Congress

Abstract number: 473

Keywords: Cadaveric organs, Graft function, Kidney transplantation

Session Information

Session Name: Concurrent Session: Kidney: Risk Prediction

Session Type: Concurrent Session

Date: Tuesday, May 5, 2015

Session Time: 4:00pm-5:30pm

Presentation Time: 5:00pm-5:12pm

Location: Room 120-ABC

Background: Better prognostic markers in deceased donors(DD) are needed for determining whether to accept suboptimal DD kidneys or predicting post-transplant outcomes. Recently, neutrophil gelatinase-associated lipocalin(NGAL), kidney injury molecule-1(KIM-1), and liver-type fatty acid binding protein(L-FABP) have shown to be good biomarkers for acute and chronic kidney injury. Therefore, we performed a prospective, multicenter study to evaluate the predictive values of these biomarkers in DD for renal allograft outcomes. Methods: We included 92 DDs and their 108 transplants from 4 transplantation centers in Korea. The biomarkers were measured in donor urine samples before operation, and in recipient urine samples at 10 days after operation using ELISA. Urinary biomarker levels were adjusted to urinary creatinine levels. Protocol biopsy samples on D0 and D10 were assessed for acute and chronic histologic injury. Association of urine biomarkers with delayed graft function(DGF), acute rejection(AR), and histologic injury was analyzed. Results: The mean age of DDs was 43 years, and 32% of DDs were female. The mean age of transplants was 45 years, and 35% of transplants were female. Among DDs, 24% belonged to expanded criteria donors. AR occurred in 28(26%) and 36(33%) cases within 3 months and 1 year, respectively. DGF was observed in 17% of transplants. The median levels of NGAL, KIM-1, and L-FABP in donor urine samples were 7,462μg/mg, 0.1ng/mg, and 443ng/mg, respectively. Post-transplant urine levels of NGAL, KIM-1, and L-FABP decreased significantly, and their median levels were 1,915μg/mg, 0.02ng/mg, and 184ng/mg, respectively. Both donor urinary NGAL(p=0.008) and L-FABP(p=0.007) were significantly higher in patients with DGF than those in patients without DGF. Receiver operating characteristic analysis showed that donor urinary NGAL (area under the curve(AUC), 0.70) and L-FABP(AUC, 0.702) were predictive of DGF. Donor urinary NGAL(p=0.036) and KIM-1(p=0.003) were associated with acute tubular injury on D10 protocol biopsy. However, no biomarker predicted AR either within 3 months or 1 year. Conclusions: Donor urinary NGAL is an useful biomarker for predicting DGF and acute tubular injury after kidney transplantation.

To cite this abstract in AMA style:

Kang S, Im H, Lee J, Koo T, Lee S, Park S, Kim S-J, Ahn C, Yang J. Biomarkers of Deceased Donors for the Prediction of Renal Allograft Outcomes [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/biomarkers-of-deceased-donors-for-the-prediction-of-renal-allograft-outcomes/. Accessed May 19, 2025.

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