title: Assessment of neutrophil gelatinase-associated lipocalin in the brain-dead organ donor to predict immediate graft function in kidney recipients: a prospective, multicenter study.
abstract: BACKGROUND
  Delayed graft function is a major determinant of long-term renal allograft survival. Despite considerable efforts to improve donor selection and matching, incidence of delayed graft function remains close to 25%. As neutrophil gelatinase-associated lipocalin (NGAL) has been shown to predict acute renal failure, the authors tested the hypothesis that NGAL measurement in brain-dead donors predicts delayed graft function in kidney recipients.
  
  
  METHODS
  In a prospective, multicenter, observational study, serum NGAL was measured in donors at the time of transfer to operating room. The primary endpoint was the delayed graft function, defined as the need for renal replacement therapy during the first week posttransplantation.
  
  
  RESULTS
  Among 159 included brain-dead donors, 146 were analyzable leading to 243 renal transplantations. Of these, 56 (23%) needed renal replacement therapy. Donors' NGAL values were similar in case of both delayed and normal graft function in recipients. The area under the receiver-operating curve for NGAL to predict the need for renal replacement therapy before day 8 was 0.50 (95% CI, 0.42 to 0.59). The area under curve for NGAL to predict failure to return to a normal graft function at day 8 was 0.51 (95% CI, 0.44 to 0.59). Using multivariate analysis, NGAL was not associated to the need for renal replacement therapy (odds ratio, 0.99; 95% CI, 0.98 to1.00) or failure to return to a normal graft function at day 8 (odds ratio, 1.00; 95% CI, 0.99 to 1.00).
  
  
  CONCLUSIONS
  NGAL measurement in brain-dead donors at the time of recovery failed to predict delayed or normal graft function in kidney recipients.
authors.affiliation: From the Department of Anesthesiology and Critical Care (L.M., G.L., J.-Y.L.) and Department of Biostatistics and Clinical Epidemiology (S.B., S.A.), Nîmes University Hospital, Place du Pr Robert Debré, Nîmes, France; Department of Anesthesiology and Critical Care, CHU Pitié-Salpêtrière, Paris, France, and UMRS INSERM 956, Université Pierre et Marie Curie, Paris, France (A.N.-R., B.R.); Department of Anesthesiology and Critical Care, CHU Lapeyronie, Montpellier, France (O.M.); Department of Anesthesiology and Critical Care, CHU Timone, Marseille, France (J.-C.C.); and Department of Anesthesiology and Critical Care, CHU Saint Eloi, Montpellier, France (F.V.).
authors.forename: Laurent
authors.initials: L
authors.lastname: Muller
authors.forename: Armelle
authors.initials: A
authors.lastname: Nicolas-Robin
authors.forename: Sophie
authors.initials: S
authors.lastname: Bastide
authors.forename: Orianne
authors.initials: O
authors.lastname: Martinez
authors.forename: Guillaume
authors.initials: G
authors.lastname: Louart
authors.forename: Jean-Christian
authors.initials: JC
authors.lastname: Colavolpe
authors.forename: Florence
authors.initials: F
authors.lastname: Vachiery
authors.forename: Sandrine
authors.initials: S
authors.lastname: Alonso
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Lefrant
authors.forename: Bruno
authors.initials: B
authors.lastname: Riou
mesh_terms: D000209:Acute-Phase Proteins / Q000235:genetics; D000328:Adult; D019540:Area Under Curve; D001926:Brain Death / Q000097:blood*; D051799:Delayed Graft Function / Q000097:blood* / Q000453:epidemiology* / Q000235:genetics; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods / Q000706:statistics & numerical data*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000097:blood* / Q000235:genetics; D012372:ROC Curve; D014019:Tissue Donors / Q000706:statistics & numerical data*
chemical_list: D000209:Acute-Phase Proteins; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins