title: Serum liver-type fatty acid-binding protein predicts recovery of graft function after kidney transplantation from donors after cardiac death.
abstract: Kidneys procured by donation after cardiac death (DCD) may increase the donor pool but are associated with high incidence of delayed graft function (DGF). Urinary liver-type fatty acid-binding protein (L-FABP) level is an early biomarker of renal injury after kidney transplantation (KTx); however, its utility is limited in DGF cases owing to urine sample unavailability. We examined whether serum L-FABP level predicts functional recovery of transplanted DCD kidneys. Consecutive patients undergoing KTx from living related donors (LD), brain-dead donors (BD), or DCD were retrospectively enrolled. Serum L-FABP levels were measured from samples collected before and after KTx. Serum L-FABP decreased rapidly in patients with immediate function, slowly in DGF patients, and somewhat increased in DGF patients requiring hemodialysis (HD) for >1 wk. Receiver-operating characteristic curve analysis demonstrated that DGF was predicted with 84% sensitivity (SE) and 86% specificity (SP) at cutoff of 9.0 ng/mL on post-operative day (POD) 1 and 68% SE and 90% SP at 6.0 on POD 2. DGF >7 d was predicted with 83% SE and 78% SP at 11.0 on POD 1 and 67% SE and 78% SP at 6.5 on POD 2. Serum L-FABP levels may predict graft recovery and need for HD after DCD KTx.
authors.affiliation: Department of Urology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawai
authors.forename: Mamoru
authors.initials: M
authors.lastname: Kusaka
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kitagawa
authors.forename: Junichi
authors.initials: J
authors.lastname: Ishii
authors.forename: Naohiko
authors.initials: N
authors.lastname: Fukami
authors.forename: Takahiro
authors.initials: T
authors.lastname: Maruyama
authors.forename: Hitomi
authors.initials: H
authors.lastname: Sasaki
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: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D001926:Brain Death; D002648:Child; D003643:Death; D051799:Delayed Graft Function / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D015415:Biomarkers; C493319:FABP1 protein, human; D050556:Fatty Acid-Binding Proteins
keywords: delayed graft function; donation after cardiac death; ischemia/reperfusion injury; kidney transplantation; liver-type fatty acid-binding protein