title: Neutrophil gelatinase-associated lipocalin as an early biomarker of acute kidney injury in liver transplantation.
abstract: BACKGROUND
  Acute kidney injury (AKI) is a common complication and a significant prognostic factor of long-term outcome in patients undergoing liver transplantation. We evaluated the utility of urine and plasma neutrophil gelatinase-associated lipocalin (NGAL) concentrations as biomarkers of AKI during and after liver transplantation.
  
  
  METHODS
  We prospectively enrolled 19 adult patients who underwent living-related liver transplantation (LRLT). Serial blood and urine samples were collected at baseline and at 2, 4, 10, 16, 24, 30, 40, and 48 h after reperfusion, and their concentrations of NGAL were measured, with urinary NGAL corrected by urinary creatinine concentration to compensate for urine output. AKI was defined by Risk-Injury-Failure-Loss-End-stage kidney disease (RIFLE) criteria as a ≥50% increase in serum creatinine from baseline.
  
  
  RESULTS
  Eleven of 19 patients were diagnosed with AKI according to RIFLE criteria. Urinary NGAL/urine creatinine ratio increased immediately after reperfusion and peaked four h later and preceded a ≥50% elevation in serum Cr by 19.0 h (p = 0.001). Plasma NGAL also tended to be elevated 13.0 h earlier than serum creatinine (p = 0.075).
  
  
  CONCLUSIONS
  The urinary NGAL/urine creatinine ratio may be an early biomarker of AKI in adult patients undergoing LRLT.
authors.affiliation: Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Tae-Dong
authors.initials: TD
authors.lastname: Jeong
authors.forename: Sollip
authors.initials: S
authors.lastname: Kim
authors.forename: Woochang
authors.initials: W
authors.lastname: Lee
authors.forename: Gi-Won
authors.initials: GW
authors.lastname: Song
authors.forename: Young-Kug
authors.initials: YK
authors.lastname: Kim
authors.forename: Sail
authors.initials: S
authors.lastname: Chun
authors.forename: Sung-Gyu
authors.initials: SG
authors.lastname: Lee
authors.forename: Won-Ki
authors.initials: WK
authors.lastname: Min
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D000209:Acute-Phase Proteins / Q000378:metabolism*; D000328:Adult; D015415:Biomarkers / Q000032:analysis*; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000378:metabolism*; D008107:Liver Diseases / Q000150:complications* / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000378:metabolism*; D012372:ROC Curve
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D003404:Creatinine