Cargando…
Pre-transplant Evaluation of Donor Urinary Biomarkers can Predict Reduced Graft Function After Deceased Donor Kidney Transplantation
Several recipient biomarkers are reported to predict graft dysfunction, but these are not useful in decision making for the acceptance or allocation of deceased donor kidneys; thus, it is necessary to develop donor biomarkers predictive of graft dysfunction. To address this issue, we prospectively e...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839919/ https://www.ncbi.nlm.nih.gov/pubmed/26986138 http://dx.doi.org/10.1097/MD.0000000000003076 |
_version_ | 1782428217052758016 |
---|---|
author | Koo, Tai Yeon Jeong, Jong Cheol Lee, Yonggu Ko, Kwang-Pil Lee, Kyoung-Bun Lee, Sik Park, Suk Joo Park, Jae Berm Han, Miyeon Lim, Hye Jin Ahn, Curie Yang, Jaeseok |
author_facet | Koo, Tai Yeon Jeong, Jong Cheol Lee, Yonggu Ko, Kwang-Pil Lee, Kyoung-Bun Lee, Sik Park, Suk Joo Park, Jae Berm Han, Miyeon Lim, Hye Jin Ahn, Curie Yang, Jaeseok |
author_sort | Koo, Tai Yeon |
collection | PubMed |
description | Several recipient biomarkers are reported to predict graft dysfunction, but these are not useful in decision making for the acceptance or allocation of deceased donor kidneys; thus, it is necessary to develop donor biomarkers predictive of graft dysfunction. To address this issue, we prospectively enrolled 94 deceased donors and their 109 recipients who underwent transplantation between 2010 and 2013 at 4 Korean transplantation centers. We investigated the predictive values of donor urinary neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and L-type fatty acid binding protein (L-FABP) for reduced graft function (RGF). We also developed a prediction model of RGF using these donor biomarkers. RGF was defined as delayed or slow graft function. Multiple logistic regression analysis was used to generate a prediction model, which was internally validated using a bootstrapping method. Multiple linear regression analysis was used to assess the association of biomarkers with 1-year graft function. Notably, donor urinary NGAL levels were associated with donor AKI (P = 0.014), and donor urinary NGAL and L-FABP were predictive for RGF, with area under the receiver-operating characteristic curves (AUROC) of 0.758 and 0.704 for NGAL and L-FABP, respectively. The best-fit model including donor urinary NGAL, L-FABP, and serum creatinine conveyed a better predictive value for RGF than donor serum creatinine alone (P = 0.02). In addition, we generated a scoring method to predict RGF based on donor urinary NGAL, L-FABP, and serum creatinine levels. Diagnostic performance of the RGF prediction score (AUROC 0.808) was significantly better than that of the DGF calculator (AUROC 0.627) and the kidney donor profile index (AUROC 0.606). Donor urinary L-FABP levels were also predictive of 1-year graft function (P = 0.005). Collectively, these findings suggest donor urinary NGAL and L-FABP to be useful biomarkers for RGF, and support the use of a new scoring system based on donor biomarkers to facilitate decision-making in acceptance and allocation of deceased donor kidneys and contribute to maximal organ utilization. |
format | Online Article Text |
id | pubmed-4839919 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-48399192016-06-02 Pre-transplant Evaluation of Donor Urinary Biomarkers can Predict Reduced Graft Function After Deceased Donor Kidney Transplantation Koo, Tai Yeon Jeong, Jong Cheol Lee, Yonggu Ko, Kwang-Pil Lee, Kyoung-Bun Lee, Sik Park, Suk Joo Park, Jae Berm Han, Miyeon Lim, Hye Jin Ahn, Curie Yang, Jaeseok Medicine (Baltimore) 5200 Several recipient biomarkers are reported to predict graft dysfunction, but these are not useful in decision making for the acceptance or allocation of deceased donor kidneys; thus, it is necessary to develop donor biomarkers predictive of graft dysfunction. To address this issue, we prospectively enrolled 94 deceased donors and their 109 recipients who underwent transplantation between 2010 and 2013 at 4 Korean transplantation centers. We investigated the predictive values of donor urinary neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and L-type fatty acid binding protein (L-FABP) for reduced graft function (RGF). We also developed a prediction model of RGF using these donor biomarkers. RGF was defined as delayed or slow graft function. Multiple logistic regression analysis was used to generate a prediction model, which was internally validated using a bootstrapping method. Multiple linear regression analysis was used to assess the association of biomarkers with 1-year graft function. Notably, donor urinary NGAL levels were associated with donor AKI (P = 0.014), and donor urinary NGAL and L-FABP were predictive for RGF, with area under the receiver-operating characteristic curves (AUROC) of 0.758 and 0.704 for NGAL and L-FABP, respectively. The best-fit model including donor urinary NGAL, L-FABP, and serum creatinine conveyed a better predictive value for RGF than donor serum creatinine alone (P = 0.02). In addition, we generated a scoring method to predict RGF based on donor urinary NGAL, L-FABP, and serum creatinine levels. Diagnostic performance of the RGF prediction score (AUROC 0.808) was significantly better than that of the DGF calculator (AUROC 0.627) and the kidney donor profile index (AUROC 0.606). Donor urinary L-FABP levels were also predictive of 1-year graft function (P = 0.005). Collectively, these findings suggest donor urinary NGAL and L-FABP to be useful biomarkers for RGF, and support the use of a new scoring system based on donor biomarkers to facilitate decision-making in acceptance and allocation of deceased donor kidneys and contribute to maximal organ utilization. Wolters Kluwer Health 2016-03-18 /pmc/articles/PMC4839919/ /pubmed/26986138 http://dx.doi.org/10.1097/MD.0000000000003076 Text en Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | 5200 Koo, Tai Yeon Jeong, Jong Cheol Lee, Yonggu Ko, Kwang-Pil Lee, Kyoung-Bun Lee, Sik Park, Suk Joo Park, Jae Berm Han, Miyeon Lim, Hye Jin Ahn, Curie Yang, Jaeseok Pre-transplant Evaluation of Donor Urinary Biomarkers can Predict Reduced Graft Function After Deceased Donor Kidney Transplantation |
title | Pre-transplant Evaluation of Donor Urinary Biomarkers can Predict Reduced Graft Function After Deceased Donor Kidney Transplantation |
title_full | Pre-transplant Evaluation of Donor Urinary Biomarkers can Predict Reduced Graft Function After Deceased Donor Kidney Transplantation |
title_fullStr | Pre-transplant Evaluation of Donor Urinary Biomarkers can Predict Reduced Graft Function After Deceased Donor Kidney Transplantation |
title_full_unstemmed | Pre-transplant Evaluation of Donor Urinary Biomarkers can Predict Reduced Graft Function After Deceased Donor Kidney Transplantation |
title_short | Pre-transplant Evaluation of Donor Urinary Biomarkers can Predict Reduced Graft Function After Deceased Donor Kidney Transplantation |
title_sort | pre-transplant evaluation of donor urinary biomarkers can predict reduced graft function after deceased donor kidney transplantation |
topic | 5200 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839919/ https://www.ncbi.nlm.nih.gov/pubmed/26986138 http://dx.doi.org/10.1097/MD.0000000000003076 |
work_keys_str_mv | AT kootaiyeon pretransplantevaluationofdonorurinarybiomarkerscanpredictreducedgraftfunctionafterdeceaseddonorkidneytransplantation AT jeongjongcheol pretransplantevaluationofdonorurinarybiomarkerscanpredictreducedgraftfunctionafterdeceaseddonorkidneytransplantation AT leeyonggu pretransplantevaluationofdonorurinarybiomarkerscanpredictreducedgraftfunctionafterdeceaseddonorkidneytransplantation AT kokwangpil pretransplantevaluationofdonorurinarybiomarkerscanpredictreducedgraftfunctionafterdeceaseddonorkidneytransplantation AT leekyoungbun pretransplantevaluationofdonorurinarybiomarkerscanpredictreducedgraftfunctionafterdeceaseddonorkidneytransplantation AT leesik pretransplantevaluationofdonorurinarybiomarkerscanpredictreducedgraftfunctionafterdeceaseddonorkidneytransplantation AT parksukjoo pretransplantevaluationofdonorurinarybiomarkerscanpredictreducedgraftfunctionafterdeceaseddonorkidneytransplantation AT parkjaeberm pretransplantevaluationofdonorurinarybiomarkerscanpredictreducedgraftfunctionafterdeceaseddonorkidneytransplantation AT hanmiyeon pretransplantevaluationofdonorurinarybiomarkerscanpredictreducedgraftfunctionafterdeceaseddonorkidneytransplantation AT limhyejin pretransplantevaluationofdonorurinarybiomarkerscanpredictreducedgraftfunctionafterdeceaseddonorkidneytransplantation AT ahncurie pretransplantevaluationofdonorurinarybiomarkerscanpredictreducedgraftfunctionafterdeceaseddonorkidneytransplantation AT yangjaeseok pretransplantevaluationofdonorurinarybiomarkerscanpredictreducedgraftfunctionafterdeceaseddonorkidneytransplantation |