title: Effect of high-dose erythropoietin on graft function after kidney transplantation: a randomized, double-blind clinical trial.
abstract: OBJECTIVE
  Delayed graft function (DGF) is associated with adverse long-term outcomes after deceased-donor kidney (DDK) transplantation. Ischemia-reperfusion injury plays a crucial role in the development of DGF. On the basis of promising animal data, this study evaluated any potential benefits of erythropoietin-alfa (EPO-α) given intra-arterially at the time of reperfusion of renal allograft on the degree of allograft function, as well as tubular cell injury measured by urinary biomarkers in the early post-transplant period.
  
  
  METHODS
  A prospective, randomized, double-blind, placebo-controlled clinical trial was conducted to evaluate the influence of EPO-α administered intraoperatively on the outcomes of DDK transplantations performed at the study center between March 2007 and July 2009.
  
  
  RESULTS
  Seventy-two patients were randomly assigned to EPO-α (n=36) or placebo (n=36). The incidences of DGF, slow graft function, and immediate graft function did not significantly differ between the treatment and control groups (41.7% versus 47.2%, 25.0% versus 36.1%, and 33.3% versus 16.7%, respectively; P=0.24). The groups had similar levels of urinary biomarkers, including neutrophil gelatinase-associated lipocalin and IL-18 at multiple times points soon after transplantation; urinary output during the first 3 postoperative days; 1-month renal function; and BP readings, hemoglobin, and adverse effects during the first month.
  
  
  CONCLUSIONS
  This study did not show any clinically demonstrable beneficial effects of high-dose EPO-α given intra-arterially during the early reperfusion phase in DDK transplant recipients in terms of reducing the incidence of DGF or improving short-term allograft function.
authors: Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA. ksureshk@wpahs.org
authors: Kalathil K
authors: KK
authors: Sureshkumar
authors: Sabiha M
authors: SM
authors: Hussain
authors: Tina Y
authors: TY
authors: Ko
authors: Ngoc L
authors: NL
authors: Thai
authors: Richard J
authors: RJ
authors: Marcus
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001794:Blood Pressure / Q000187:drug effects; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood / Q000652:urine; D051799:Delayed Graft Function / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control* / Q000652:urine; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D015994:Incidence; D007269:Injections, Intra-Arterial; D020382:Interleukin-18 / Q000652:urine; D016030:Kidney Transplantation / Q000009:adverse effects; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000652:urine; D011994:Recombinant Proteins / Q000008:administration & dosage; D015427:Reperfusion Injury / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control* / Q000652:urine; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D006454:Hemoglobins; D020382:Interleukin-18; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa; D003404:Creatinine