Associations Between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes.
1Nephrology, Yale University School of Medicine, New Haven, CT
2Renal-Electrolyte and Hypertension, University of Pennsylvania, Philadelphia, PA
3Wayne State University, Detroit, MI
4Saint Barnabas Medical Center, Livingston, NJ
5Nephrology, University Hospital, Ulm, Germany
6Nephrology, Western University, London, ON, Canada.
Meeting: 2016 American Transplant Congress
Abstract number: 100
Keywords: Graft function, Kidney transplantation
Session Information
Date: Sunday, June 12, 2016
Session Name: Concurrent Session: Delayed Graft Function and Protocol Biopsy
Session Time: 4:30pm-6:00pm
Presentation Time: 5:06pm-5:18pm
Location: Room 302
Current assessments of deceased donor kidneys lack precision in predicting recipient graft function. Mouse models have demonstrated that monocyte chemoattractant protein-1 (MCP-1) has a pivotal role in inflammation and repair after acute kidney injury (AKI). Thus, revealing the role of MCP-1 in the recovery process after deceased donor kidney procurement might enable better prediction of recipient graft outcomes.
We conducted a multicenter prospective cohort study involving deceased kidney donors from five organ procurement organizations (OPO). Donor characteristics were obtained from OPO donor charts. Recipient characteristics were obtained through the United Network for Organ Sharing database. We measured donor urine MCP-1 (uMCP-1) levels and determined associations with: donor AKI (at least doubling of serum creatinine), delayed graft function (DGF) and recipient 6-month eGFR.
The cohort included 1301 deceased donors and 2435 recipients. AKI was present in 111 (9%) of donors. Urine MCP-1 levels were significantly higher in donors with AKI, compared to donors without AKI, with median (interquartile range) of 1.35 ng/mL(0.41-3.93) versus 0.32 ng/mL (0.11-0.80). After adjusting for donor variables, each unit increase in log uMCP-1 was associated with 54% increased risk of donor AKI (RR 1.54 [95% CI 1.42- 1.67]). A total of 756 (31%) recipients developed DGF. There was no association between log uMCP-1 and risk of DGF. Higher levels of log uMCP-1 were associated with higher 6-month eGFR (0.81 ml/min per 1.73 m2 [95% CI 0.21-1.41]) after adjusting for donor, transport, recipient variables and donor urine NGAL levels. When stratifying the cohort by DGF status, the association between 6-month eGFR and uMCP-1 concentration remained significant only in the non DGF group.
In summary, donor uMCP-1 levels were strongly associated with donor AKI demonstrating the presence of inflammation and repair in the graft but were also associated with higher recipient graft function at 6 months. Hence, uMCP-1 may have a role in assessing kidney graft quality among deceased donors.
CITATION INFORMATION: Mansour S, Puthumana J, Reese P, Hall I, Doshi M, Weng F, Schröppel B, Thiessen-Philbrook H, Bimali M, Parikh C. Associations Between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Mansour S, Puthumana J, Reese P, Hall I, Doshi M, Weng F, Schröppel B, Thiessen-Philbrook H, Bimali M, Parikh C. Associations Between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/associations-between-deceased-donor-urine-mcp-1-and-kidney-transplant-outcomes/. Accessed July 21, 2018.« Back to 2016 American Transplant Congress