Date: Saturday, June 1, 2019
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall C & D
*Purpose: To explore the relationship between new biomarkers in donor blood and delayed graft function (DGF) after DCD kidney transplantation, and to evaluate the clinical value of new biomarkers in the diagnosis of DGF.
*Methods: The recipients of DCD donor kidney allotransplantation from August 2016 to December 2017 were observed and evaluated. Blood samples were collected within 12 hours on the day of donor organ extraction. Enzyme-Linked Immunosorbent Assay (ELISA) was used to detect the neutrophil gelatinase phase in donor blood samples. Neutrophil Gelatinase-associated Lipocalin (NGAL), L-type fatty acid binding protein (L-FABP), kidney injury molecule-1 (KIM-1), interleukin-18 (IL-8) are four new markers of kidney injury. Patients were divided into DGF group (delayed recovery group) and EGF group (early recovery group) according to the occurrence of DGF. The differences of four new biomarkers between the two groups were calculated, and the Receiver Operating Characteristic Curve (ROC curve) was drawn to find the best positive diagnostic boundary. The Cutoff value was used to calculate the sensitivity and specificity of a new blood marker for the diagnosis of delayed graft function recovery (DGF).
*Results: Among 70 patients with DCD, 8 had DGF (DGF group), 62 had no DGF (EGF group), and the overall incidence of DGF was 11.43%. The concentration of NGAL in serum of donors in DGF group was 521.01 +132.84 (ng/ml), while that in EGF group was 299.99 +100.03 (ng/ml), P < 0.001. The ROC curve was drawn. When the concentration of NGAL was higher than 425.15ng/ml, the sensitivity, specificity and area under the curve (AUC) were 87.5%, 90.3% and 0.891 respectively. The serum concentration of IL-18 in DGF group was 14.10+12.36 (ng/ml), in EGF group was 4.61+1.83 (ng/ml), P=0.047 (< 0.05). The ROC curve was drawn. When the concentration of IL-18 was more than 5.345 ng/ml, the sensitivity, specificity and area under the curve (AUC) were 100%, 64.5% and 0.914 respectively. There was no significant difference in serum L-FABP and KIM-1 between the two groups. The sensitivity and specificity of donor creatinine in diagnosis of DGF were 62.5%, 75.8%, and the area under curve (AUC) was 0.692.
*Conclusions: The increase of NGAL and IL-18 in donor blood before operation is more sensitive and specific than traditional creatinine in the diagnosis of DGF after renal transplantation.
To cite this abstract in AMA style:Zheng X. Evaluation of Delayed Renal Allograft Function after DCD with New Biomarkers in Donor Blood [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/evaluation-of-delayed-renal-allograft-function-after-dcd-with-new-biomarkers-in-donor-blood/. Accessed January 16, 2021.
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