title: Is plasma and urine neutrophil gelatinase-associated lipocalin (NGAL) determination in donors and recipients predictive of renal function after kidney transplantation?
abstract: OBJECTIVE
  Delayed graft function (DGF) is still a major issue in kidney transplantation. Plasma and urine neutrophil gelatinase-associated lipocalin (NGAL) were evaluated in a population of kidney donors and recipients to investigate their performance to predict early renal function.
  
  
  METHODS
  Plasma (pNGAL) and urine (uNGAL) samples were obtained from donors before organ procurement, and from recipients before transplantation, and then 6, 24 and 48h after the procedure. Kidney transplantations were performed from both living donors (LDs, n=17) and deceased donors (DDs, n=80). Recovery of renal function was evaluated as the time to reach serum creatinine <2mg/l or glomerular filtration rate (GFR)>40mL/min. Logistic regression was used to assess the ability of different variables to predict the occurrence of DGF.
  
  
  RESULTS
  Plasma NGAL levels were significantly lower in LDs than in DDs. No episodes of DGF were recorded among LD kidney recipients, but DGF was observed in 25% of patients in the DD group. There was no correlation between donor pNGAL and uNGAL values and the occurrence of post-transplant DGF. Recipient pNGAL performed better than uNGAL in terms of predicting DGF occurrence. Donor pNGAL and uNGAL values did not influence the time needed to reach serum creatinine levels of <2mg/dl after transplantation. When time to reach eGFR of >40mL/min is considered, only donor uNGAL seems to be a predictor of graft function recovery. However, recipient pNGAL values obtained 24 and 48h after transplantation, but not uNGAL values, were found to be a significant predictor of graft function recovery.
  
  
  CONCLUSIONS
  Plasma NGAL level determination in recipients, but not in donors, proved to be a reliable predictor of DGF occurrence and renal function restoration, but too long for an interval to be able to compete with biomarkers currently used in clinical practice.
authors.affiliation: Surgery and Abdominal Transplantation Division, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 Avenue Hippocrate, Brussels, Belgium.
authors.forename: Antoine
authors.initials: A
authors.lastname: Buemi
authors.affiliation: Clinical Chemistry Department Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 Avenue Hippocrate, Brussels, Belgium.
authors.forename: Flora
authors.initials: F
authors.lastname: Musuamba
authors.affiliation: Clinical Chemistry Department Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 Avenue Hippocrate, Brussels, Belgium.
authors.forename: Stephan
authors.initials: S
authors.lastname: Frederic
authors.affiliation: Clinical Chemistry Department Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 Avenue Hippocrate, Brussels, Belgium.
authors.forename: Anne
authors.initials: A
authors.lastname: Douhet
authors.affiliation: Surgery and Abdominal Transplantation Division, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 Avenue Hippocrate, Brussels, Belgium.
authors.forename: Martine
authors.initials: M
authors.lastname: De Meyer
authors.affiliation: Surgery and Abdominal Transplantation Division, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 Avenue Hippocrate, Brussels, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: De Pauw
authors.affiliation: Surgery and Abdominal Transplantation Division, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 Avenue Hippocrate, Brussels, Belgium.
authors.forename: Tom
authors.initials: T
authors.lastname: Darius
authors.affiliation: Nephrology Division, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 Avenue Hippocrate, Brussels, Belgium.
authors.forename: Nada
authors.initials: N
authors.lastname: Kanaan
authors.affiliation: Clinical Chemistry Department Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 Avenue Hippocrate, Brussels, Belgium.
authors.forename: Pierre
authors.initials: P
authors.lastname: Wallemacq
authors.affiliation: Surgery and Abdominal Transplantation Division, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 Avenue Hippocrate, Brussels, Belgium. Electronic address: michel.mourad@uclouvain.be.
authors.forename: Michel
authors.initials: M
authors.lastname: Mourad
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine*; D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D051799:Delayed Graft Function / Q000097:blood / Q000473:pathology / Q000652:urine; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood* / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000097:blood* / Q000652:urine*; D014019:Tissue Donors; D066027:Transplant Recipients
chemical_list: D000209:Acute-Phase Proteins; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D003404:Creatinine
keywords: Kidney transplant; NGAL; Renal function