Do tissue damage biomarkers used to assess machine-perfused NHBD kidneys predict long-term renal function post-transplant?
BACKGROUND
Renal transplantation in many units is limited by the availability of donor organs. Kidneys obtained from non-heart-beating donors (NHBD) represent an important resource, with the potential to substantially increase the available donor organ pool. Such kidneys are associated with increased warm ischaemic tissue injury which may be assessed by hypothermic machine perfusion. Within our transplant centre, a key component of such damage assessment and viability screening involves the quantification of the tissue damage biomarkers glutathione S-transferase in kidney perfusates.


METHODS
Since 1998, 126 NHBD kidneys were machine-perfused prior to implantation, resulting in 74 transplants. Kidney perfusate samples were assayed for glutathione S-transferase in "real time", and alanine aminopeptidase and fatty acid binding protein in "retrospect".


RESULTS
The pre-transplant concentration of these tissue injury biomarkers determined pre-transplant did not correlate with subsequent longer-term renal function, as assessed by measurement of serum creatinine (tGST: Spearman correlation r=-0.02; Ala-AP: r=0.02; H-FABP: r=-0.05) and creatinine clearance (tGST: r=0.08; Ala-AP: r=-0.02; H-FABP: r=0.14) for those kidneys that had passed their viability tests.


CONCLUSIONS
Thus whilst these biomarkers may represent reliable pre-transplant indicators of immediate kidney viability and short-term kidney function, they do not predict the efficacy of renal function in the longer term.
Gok
Muhammed A
MA
Renal/Liver Transplant Unit, The Freeman Hospital, University of Newcastle Upon Tyne, Level 5, NE7 7DN, Newcastle Upon Tyne, England, UK. m.a.gok@ncl.ac.uk
Pelzers
Maurice
M
Glatz
Jan F C
JF
Shenton
Brian K
BK
Buckley
Pamela E
PE
Peaston
Robert
R
Cornell
Chris
C
Mantle
Dave
D
Soomro
Naeem
N
Jaques
Bryon C
BC
Manas
Derek M
DM
Talbot
David
D
D015415:Biomarkers / Q000097:blood*; D018826:CD13 Antigens / Q000097:blood; D002352:Carrier Proteins / Q000097:blood; D003404:Creatinine / Q000097:blood; D050556:Fatty Acid-Binding Proteins; D005500:Follow-Up Studies; D005982:Glutathione Transferase / Q000097:blood; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000473:pathology* / Q000502:physiology* / Q000503:physiopathology / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D010477:Perfusion; D015996:Survival Rate; D013997:Time Factors; D014019:Tissue Donors
D015415:Biomarkers; D002352:Carrier Proteins; D050556:Fatty Acid-Binding Proteins; D003404:Creatinine; D005982:Glutathione Transferase; D018826:CD13 Antigens