title: Urinary neutrophil gelatinase-associated lipocalin and the occurrence of delayed graft function after kidney transplant.
abstract: OBJECTIVE
  To investigate the predictive value of urinary neutrophil gelatinase-associated lipocalin in the occurrence of delayed graft function after kidney transplant.
  
  
  METHODS
  In this prospective cohort study of 67 consecutive patients who received a living-related (40 patients [61%]) or deceased-donor kidney transplant (27 patients [39%]), urinary neutrophil gelatinase-associated lipocalin was determined in the first 100 mL perfusate of the donor kidney and in urine at 6 hours after transplant. Patients were followed (11 ± 7 mo) for changes in estimated glomerular filtration rate and delayed graft function.
  
  
  RESULTS
  The mean urinary neutrophil gelatinase-associated lipocalin level at 6 hours after transplant was significantly higher after deceased-donor (781 ± 452 ng/mL) than living-donor transplant (229 ± 223 ng/mL; P ≤ 0.001). The decrease in estimated glomerular filtration rate from 6 to 12 months after transplant was positively correlated with the urinary neutrophil gelatinase-associated lipocalin levels in the perfusate in living-donor transplant. A significant correlation was noted between the occurrence of delayed graft function and the urinary neutrophil gelatinase-associated lipocalin level at 6 hours after living-donor transplant. In the deceased-donor group, the occurrence of delayed graft function was correlated with urinary neutrophil gelatinase-associated lipocalin levels in the perfusate. In deceased-donor kidney transplant, the mean urinary neutrophil gelatinase-associated lipocalin level in the perfusion fluid was significantly greater from donors who had terminal serum creatinine > 150 μmol/L, and urinary neutrophil gelatinase-associated lipocalin level at 6 hours after transplant was significantly greater in transplants with longer cold ischemia time and donors who had hypertension.
  
  
  CONCLUSIONS
  Urinary neutrophil gelatinase-associated lipocalin levels in the donor kidney perfusate and 6 hours after transplant may be a useful predictor of delayed graft function and decreased graft function from 6 to 12 months after transplant.
authors.affiliation: From the Nephrology and Renal Transplantation Division, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
authors.forename: Salem
authors.initials: S
authors.lastname: Qurashi
authors.forename: Ghormullah
authors.initials: G
authors.lastname: Ghamdi
authors.forename: Maha
authors.initials: M
authors.lastname: Jaradat
authors.forename: Hani
authors.initials: H
authors.lastname: Tamim
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Aljumah
authors.forename: Waleed
authors.initials: W
authors.lastname: Tamimi
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: Al Dawood
authors.forename: Salih
authors.initials: S
authors.lastname: Binsalih
authors.forename: Abdulla
authors.initials: A
authors.lastname: Al Sayyari
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000652:urine*; D000209:Acute-Phase Proteins / Q000652:urine*; D000328:Adult; D015415:Biomarkers / Q000652:urine; D051799:Delayed Graft Function / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000652:urine*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000652:urine*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D016482:Urinalysis; D055815:Young Adult
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins