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Serum and Urinary Neutrophil Gelatinase-Associated Lipocalin as Predictive Biomarker for Acute Rejection and Delayed Graft Function after Kidney Transplantation

H. Maier, N. Vallant, M. Boecklein, M. Kofler, P. Schumpp, C. Margreiter, G. Goebel, S. Schneeberger, J. Pratschke, F. Aigner

Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Innsbruck, Austria
Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria

Meeting: 2013 American Transplant Congress

Abstract number: B1015

PURPOSE: Neutrophil gelatinase-associated lipocalin (NGAL) has emerged an early marker protein for kidney dysfunction in various clinical settings. Data on NGAL expression during acute rejection (AR) after kidney transplantation in the early postoperative phase have been missing so far. The main focus of this study was to analyze the possible implication of NGAL during AR and delayed graft function (DGF) following kidney transplantation.

MATERIAL AND METHODS: Serum and urine samples of 170 patients undergoing primary kidney transplantation since October 2010 were collected preoperatively and postoperatively from day one to 15. NGAL was analyzed by ELISA. Mean values of serum and urinary NGAL before the respective event were compared between AR (event = rejection therapy), DGF (event = last dialysis) and control (C) patients (event = discharge or 15th postoperative day) using non-paramatric Kruskall Wallis Tests without multiple test corrections. A p-value less than 0.05 was considered as significant. SPSS 17 was used for statistical calculations.

RESULTS: A total of 170 patients were included in this prospective study. Pre-evaluation of 21 patients (13 C, 4 DGF, 4 AR) showed significant differences of serum (p=0.005) and urinary NGAL (p=0.022) between control and DGF and AR. Mean values of serum NGAL (ng/ml) were as follows: 133.2 (C), 241.3 (DGF), 193.6 (AR). Mean values of urinary NGAL were as follows: 37.1 (C), 99.3 (DGF), 80.5 (AR).

CONCLUSION: Serum and urinary NGAL are sensitive markers of graft dysfunction and acute rejection in the early postoperative phase after kidney transplantation. They may accelerate initial therapy in allograft recipients with acute rejection.

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To cite this abstract in AMA style:

Maier H, Vallant N, Boecklein M, Kofler M, Schumpp P, Margreiter C, Goebel G, Schneeberger S, Pratschke J, Aigner F. Serum and Urinary Neutrophil Gelatinase-Associated Lipocalin as Predictive Biomarker for Acute Rejection and Delayed Graft Function after Kidney Transplantation [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/serum-and-urinary-neutrophil-gelatinase-associated-lipocalin-as-predictive-biomarker-for-acute-rejection-and-delayed-graft-function-after-kidney-transplantation/. Accessed May 14, 2025.

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