Abstract
Kidneys procured by donation after cardiac death (DCD) may increase the donor pool but are associated with high incidence of delayed graft function (DGF). Urinary liver-type fatty acid-binding protein (L-FABP) level is an early biomarker of renal injury after kidney transplantation (KTx); however, its utility is limited in DGF cases owing to urine sample unavailability. We examined whether serum L-FABP level predicts functional recovery of transplanted DCD kidneys. Consecutive patients undergoing KTx from living related donors (LD), brain-dead donors (BD), or DCD were retrospectively enrolled. Serum L-FABP levels were measured from samples collected before and after KTx. Serum L-FABP decreased rapidly in patients with immediate function, slowly in DGF patients, and somewhat increased in DGF patients requiring hemodialysis (HD) for >1 wk. Receiver-operating characteristic curve analysis demonstrated that DGF was predicted with 84% sensitivity (SE) and 86% specificity (SP) at cutoff of 9.0 ng/mL on post-operative day (POD) 1 and 68% SE and 90% SP at 6.0 on POD 2. DGF >7 d was predicted with 83% SE and 78% SP at 11.0 on POD 1 and 67% SE and 78% SP at 6.5 on POD 2. Serum L-FABP levels may predict graft recovery and need for HD after DCD KTx.
| Original language | English |
|---|---|
| Pages (from-to) | 749-754 |
| Number of pages | 6 |
| Journal | Clinical Transplantation |
| Volume | 28 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 01-01-2014 |
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All Science Journal Classification (ASJC) codes
- Transplantation
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Serum liver-type fatty acid-binding protein predicts recovery of graft function after kidney transplantation from donors after cardiac death. / Kawai, Akihiro; Kusaka, Mamoru; Kitagawa, Fumihiko; Ishii, Junichi; Fukami, Naohiko; Maruyama, Takahiro; Sasaki, Hitomi; Shiroki, Ryoichi; Kurahashi, Hiroki; Hoshinaga, Kiyotaka.
In: Clinical Transplantation, Vol. 28, No. 6, 01.01.2014, p. 749-754.Research output: Contribution to journal › Article
TY - JOUR
T1 - Serum liver-type fatty acid-binding protein predicts recovery of graft function after kidney transplantation from donors after cardiac death
AU - Kawai, Akihiro
AU - Kusaka, Mamoru
AU - Kitagawa, Fumihiko
AU - Ishii, Junichi
AU - Fukami, Naohiko
AU - Maruyama, Takahiro
AU - Sasaki, Hitomi
AU - Shiroki, Ryoichi
AU - Kurahashi, Hiroki
AU - Hoshinaga, Kiyotaka
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Kidneys procured by donation after cardiac death (DCD) may increase the donor pool but are associated with high incidence of delayed graft function (DGF). Urinary liver-type fatty acid-binding protein (L-FABP) level is an early biomarker of renal injury after kidney transplantation (KTx); however, its utility is limited in DGF cases owing to urine sample unavailability. We examined whether serum L-FABP level predicts functional recovery of transplanted DCD kidneys. Consecutive patients undergoing KTx from living related donors (LD), brain-dead donors (BD), or DCD were retrospectively enrolled. Serum L-FABP levels were measured from samples collected before and after KTx. Serum L-FABP decreased rapidly in patients with immediate function, slowly in DGF patients, and somewhat increased in DGF patients requiring hemodialysis (HD) for >1 wk. Receiver-operating characteristic curve analysis demonstrated that DGF was predicted with 84% sensitivity (SE) and 86% specificity (SP) at cutoff of 9.0 ng/mL on post-operative day (POD) 1 and 68% SE and 90% SP at 6.0 on POD 2. DGF >7 d was predicted with 83% SE and 78% SP at 11.0 on POD 1 and 67% SE and 78% SP at 6.5 on POD 2. Serum L-FABP levels may predict graft recovery and need for HD after DCD KTx.
AB - Kidneys procured by donation after cardiac death (DCD) may increase the donor pool but are associated with high incidence of delayed graft function (DGF). Urinary liver-type fatty acid-binding protein (L-FABP) level is an early biomarker of renal injury after kidney transplantation (KTx); however, its utility is limited in DGF cases owing to urine sample unavailability. We examined whether serum L-FABP level predicts functional recovery of transplanted DCD kidneys. Consecutive patients undergoing KTx from living related donors (LD), brain-dead donors (BD), or DCD were retrospectively enrolled. Serum L-FABP levels were measured from samples collected before and after KTx. Serum L-FABP decreased rapidly in patients with immediate function, slowly in DGF patients, and somewhat increased in DGF patients requiring hemodialysis (HD) for >1 wk. Receiver-operating characteristic curve analysis demonstrated that DGF was predicted with 84% sensitivity (SE) and 86% specificity (SP) at cutoff of 9.0 ng/mL on post-operative day (POD) 1 and 68% SE and 90% SP at 6.0 on POD 2. DGF >7 d was predicted with 83% SE and 78% SP at 11.0 on POD 1 and 67% SE and 78% SP at 6.5 on POD 2. Serum L-FABP levels may predict graft recovery and need for HD after DCD KTx.
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U2 - 10.1111/ctr.12375
DO - 10.1111/ctr.12375
M3 - Article
VL - 28
SP - 749
EP - 754
JO - Clinical Transplantation
JF - Clinical Transplantation
SN - 0902-0063
IS - 6
ER -