title: Serum neutrophil gelatinase associated lipocalin during the early postoperative period predicts the recovery of graft function after kidney transplantation from donors after cardiac death.
abstract: OBJECTIVE
  Kidneys procured from donors after cardiac death hold great potential to expand the donor pool. However, they have not yet been fully used, in part due to the high incidence of delayed graft function. Although urine neutrophil gelatinase-associated lipocalin is a well-known early biomarker for renal injury after kidney transplantation, its usefulness is limited in cases with delayed graft function because of the unavailability of a urine sample. We evaluated serum neutrophil gelatinase-associated lipocalin as a potential biomarker to predict the functional recovery of kidneys transplanted from donors after cardiac death.
  
  
  METHODS
  Consecutive patients transplanted with a kidney from a living related (39), brain dead (1) or post-cardiac death (27) donor were retrospectively enrolled in the study. Serum samples were collected serially before and after kidney transplantation. Serum neutrophil gelatinase-associated lipocalin was measured using the ARCHITECT® assay.
  
  
  RESULTS
  Average serum neutrophil gelatinase-associated lipocalin was markedly high during the pre transplantation period. It decreased rapidly after transplantation. The slope of the decrease correlated well with the recovery period. By analyzing ROC curves we determined cutoffs to predict immediate, slow or delayed graft function requiring hemodialysis for longer than 1 week with high sensitivity and specificity.
  
  
  CONCLUSIONS
  These data suggest that serial monitoring of serum neutrophil gelatinase-associated lipocalin may allow us to predict graft recovery and the need for hemodialysis after kidney transplantation from a donor after cardiac death.
authors.affiliation: Department of Urology, Fujita Health University School of Medicine, Toyoake, Japan. mkusaka@fujita-hu.ac.jp
authors.forename: Mamoru
authors.initials: M
authors.lastname: Kusaka
authors.forename: Fumi
authors.initials: F
authors.lastname: Iwamatsu
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kuroyanagi
authors.forename: Miho
authors.initials: M
authors.lastname: Nakaya
authors.forename: Manabu
authors.initials: M
authors.lastname: Ichino
authors.forename: Shigeru
authors.initials: S
authors.lastname: Marubashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Shiroki
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kurahashi
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Hoshinaga
mesh_terms: D000209:Acute-Phase Proteins; D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002648:Child; D003643:Death; D051799:Delayed Graft Function / Q000097:blood*; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D016030:Kidney Transplantation; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011518:Proto-Oncogene Proteins / Q000097:blood*; D020127:Recovery of Function; D012189:Retrospective Studies; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins