• Exp Clin Transplant · Oct 2014

    Comparative Study

    Urinary neutrophil gelatinase-associated lipocalin and the occurrence of delayed graft function after kidney transplant.

    • Salem Qurashi, Ghormullah Ghamdi, Maha Jaradat, Hani Tamim, Abdulrahman Aljumah, Waleed Tamimi, Abdulaziz Al Dawood, Salih Binsalih, and Abdulla Al Sayyari.
    • From the Nephrology and Renal Transplantation Division, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
    • Exp Clin Transplant. 2014 Oct 1;12(5):396-400.

    ObjectivesTo investigate the predictive value of urinary neutrophil gelatinase-associated lipocalin in the occurrence of delayed graft function after kidney transplant.Materials And MethodsIn 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.ResultsThe 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.ConclusionsUrinary 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.

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