title: Predictive Role of Neutrophil Gelatinase-Associated Lipocaline in Donor-Specific Antibody-Positive and Donor-Specific Antibody-Negative Renal Transplant Patients.
abstract: BACKGROUND
  Renal transplantation is the best choice for the treatment of dialysis patients with end-stage renal failure because it provides better quality of life and more life time. However, despite successful surgical techniques, immunological issues in kidney transplantation are not completely resolved. Thus, after transplantation, patients must be followed up closely. Although patient follow-up with the use of creatinine and renal biopsy are common, it is thought that biopsy is too invasive and that creatinine is unreliable. Hence, new parameters that correlate with the patient's immunological condition are needed in clinical monitoring.
  
  
  METHODS
  One of the biomarkers that has been studied recently is neutrophil gelatinase-associated lipocalin (NGAL). Its diagnostic value in cases of acute renal failure, delayed graft function, and IgA nephropathy is widely investigated. However, data are insufficient as to whether NGAL can be used for follow-up in the chronic process after renal transplantation. We aimed to investigate the predictive value of NGAL in terms of rejection in donor-specific antibody (DSA)-positive and DSA-negative renal transplant patients. Ninety patients were included.
  
  
  RESULTS
  We found that rejection rates were higher in patients whose NGAL values were ≥ 50 and DSA-positive. Delayed graft function was seen more frequently in patients whose NGAL values were ≥ 50.
  
  
  CONCLUSIONS
  An increase in NGAL level does not always indicate renal injury because NGAL is also an acute-phase reactant. NGAL cannot be used alone to diagnose rejection, but, if NGAL level is high, it is necessary to study DSA, and sub-clinical rejection must be researched.
authors: Department of Surgery, Ankara University, Faculty of Medicine, Ankara, Turkey.
authors: E
authors: E
authors: Mamatov
authors: Department of Surgery, Ankara University, Faculty of Medicine, Ankara, Turkey.
authors: A F
authors: AF
authors: Kocaay
authors: Department of Surgery, Etimesgut State Hospital, Ankara, Turkey. Electronic address: mali.koc@gmail.com.
authors: M A
authors: MA
authors: Koc
authors: Department of Nephrology, Ankara University, Faculty of Medicine, Ankara, Turkey.
authors: Z K
authors: ZK
authors: Celebi
authors: Department of Nephrology, Ankara University, Faculty of Medicine, Ankara, Turkey.
authors: S
authors: S
authors: Sengül
authors: Department of Nephrology, Ankara University, Faculty of Medicine, Ankara, Turkey.
authors: K
authors: K
authors: Keven
authors: Department of Immunology, Ankara University, Faculty of Medicine, Ankara, Turkey.
authors: H
authors: H
authors: Tutkak
authors: Department of Surgery, Ankara University, Faculty of Medicine, Ankara, Turkey.
authors: A
authors: A
authors: Tuzuner
mesh_terms: D000209:Acute-Phase Proteins / Q000276:immunology / Q000378:metabolism*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D051799:Delayed Graft Function / Q000276:immunology* / Q000378:metabolism; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D000071068:Lipocalin-2; D054834:Lipocalins / Q000276:immunology / Q000378:metabolism*; D008297:Male; D011518:Proto-Oncogene Proteins / Q000276:immunology / Q000378:metabolism*; D014019:Tissue Donors
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins