title: Plasma neutrophil gelatinase-associated lipocalin in kidney transplantation and early renal function prediction.
abstract: BACKGROUND
  This prospective observational study aimed to assess the relevance of serial postoperative plasma neutrophil gelatinase-associated lipocalin (NGAL) measurements on prediction of early renal transplant function.
  
  
  METHODS
  Plasma NGAL (pNGAL) was measured (Triage NGAL Test; Biosite Inc., Inverness Medical) in 41 patients scheduled for kidney transplantation from deceased or living donors, immediately before and after surgery, and at 12 hr, day 1, day 3, and day 7. A delayed graft function (DGF) was defined as the need for dialysis during the first week. The results were expressed as median (Q1, Q3).
  
  
  RESULTS
  Of the 41 consecutive patients enrolled, all had a high preoperative pNGAL level: 453 ng/mL (382, 595). Fifteen (36.6%) presented a DGF. In patients with DGF, pNGAL was significantly higher at 12 hr (571 [467, 634] vs. 242 [158, 299] ng/mL, P<0.0001) and at day 1 (466 [356, 627] vs. 165 [91, 248] ng/mL, P<0.0001). A pNGAL higher than 400 ng/mL 12 hr after transplantation predicted DGF with a sensitivity of 93.3%, a specificity of 88.5%, and an odds ratio of 63.2 (P=0.0004). This predictive performance was higher than for plasma creatinine.
  
  
  CONCLUSIONS
  pNGAL level early and accurately predicted DGF after renal transplantation. pNGAL measurements allowed monitoring of the renal function in this striking situation of ischemia-reperfusion aggression. Early identification of patients at risk of DGF, before graft lesions are consolidated, opens the field of a precise monitoring of renal injury and the impact of future protective therapeutics.
authors.affiliation: Service d'Anesthésie-Réanimation, Hôpital St-Louis, Paris, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Bataille
authors.forename: Samia
authors.initials: S
authors.lastname: Abbas
authors.forename: Oren
authors.initials: O
authors.lastname: Semoun
authors.forename: Éric
authors.initials: É
authors.lastname: Bourgeois
authors.forename: Olivier
authors.initials: O
authors.lastname: Marie
authors.forename: Francine
authors.initials: F
authors.lastname: Bonnet
authors.forename: Matthieu
authors.initials: M
authors.lastname: Resche-Rigon
authors.forename: Imad
authors.initials: I
authors.lastname: Abboud
authors.forename: Marie-Reine
authors.initials: MR
authors.lastname: Losser
authors.forename: Laurent
authors.initials: L
authors.lastname: Jacob
mesh_terms: D000209:Acute-Phase Proteins; D000328:Adult; D015415:Biomarkers / Q000097:blood; D051799:Delayed Graft Function / Q000097:blood* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007668:Kidney / Q000502:physiology*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D016030:Kidney Transplantation / Q000502:physiology*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000097:blood*; D006435:Renal Dialysis; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins