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delayed graft function and biomarker

Kenneth R Williams, Christopher M Colangelo, Lin Hou, Lisa Chung, Justin M Belcher, Thomas Abbott, Isaac E Hall, Hongyu Zhao, Lloyd G Cantley, Chirag R Parikh
PURPOSE: Development of delayed graft function (DGF) following kidney transplant is associated with poor outcomes. An ability to rapidly identify patients with DGF versus those with immediate graft function (IGF) may facilitate the treatment of DGF and the research needed to improve prognosis. The purpose of this study was to use a Targeted Urine Proteome Assay to identify protein biomarkers of delayed recovery from kidney transplant. EXPERIMENTAL DESIGN: Potential biomarkers were identified using the Targeted Urine Proteome (MRM) Assay to interrogate the relative DGF/IGF levels of expression of 167 proteins in urine taken 12-18 h after kidney implantation from 21 DGF, 15 SGF (slow graft function), and 16 IGF patients...
March 6, 2017: Proteomics. Clinical Applications
Aydın Güçlü, Cengiz Koçak, Fatma E Koçak, Raziye Akçılar, Yavuz Dodurga, Aydın Akçılar, Levent Elmas
BACKGROUND: Acute renal failure is commonly seen in the perioperative period. Ischemia-reperfusion (IR) injury plays a major role in acute renal failure and delayed graft function. MicroRNAs (miRs), which are pivotal modulators of cell activities, offer a major opportunity for affective diagnosis and treatment strategies because they are tissue specific and in the center of gene expression modulation. The effect of bardoxolone methyl (BM) on miR-21, miR-223-5p, and miR-125b in renal IR injury was evaluated in this study...
January 2017: Journal of Surgical Research
Björn Nashan, Mario Abbud-Filho, Franco Citterio
Delayed graft function (DGF) remains a major barrier to improved outcomes after kidney transplantation. High-risk transplant recipients can be identified, but no definitive prediction model exists. Novel biomarkers to predict DGF in the first hours post-transplant, such as neutrophil gelatinase-associated lipocalin (NGAL), are under investigation. Donor management to minimize the profound physiological consequences of brain death is highly complex. A hormonal resuscitation package to manage the catecholamine "storm" that follows brain death is recommended...
October 2016: Clinical Transplantation
Patricia Hirt-Minkowski, Julie Ho, Ang Gao, Patrizia Amico, Michael T Koller, Helmut Hopfer, David N Rush, Peter W Nickerson, Stefan Schaub
UNLABELLED: Predictive biomarkers for long-term renal allograft outcome could help to individualize follow-up strategies and therapeutic interventions. METHODS: We investigated the predictive value of urinary CXC chemokine ligand 10 (CXCL10) measured at different timepoints (ie, at 3 and 6 months, and mean of 3 and 6 months coined CXCL10-burden) for long-term allograft outcomes in 154 patients. The primary outcome was a composite graft endpoint of death-censored allograft loss and/or biopsy-proven rejection and/or decline of estimated glomerular filtration rate greater than 20% occurring beyond 6 months after transplantation...
September 2015: Transplantation Direct
J Malyszko, R Kowalewski, J Glowinski, J Malyszko, E Koc-Zorawska, I Glowinska, U Lebkowska, M Gacko
BACKGROUND: Hepcidin is a peptide hormone that regulates iron homeostasis. Hepcidin may represent an early, predictive biomarker of acute kidney injury, another model of ischemia-reperfusion injury. Urinary hepcidin-25 has been shown to be elevated in patients who do not develop acute kidney injury. Creatinine is an unreliable indicator during acute changes in kidney; therefore, the aim of the study was to assess whether hepcidin could predict renal outcome in 31 consecutive patients undergoing kidney allograft transplantation...
June 2016: Transplantation Proceedings
Jeremy Puthumana, Isaac E Hall, Peter P Reese, Bernd Schröppel, Francis L Weng, Heather Thiessen-Philbrook, Mona D Doshi, Veena Rao, Chun Geun Lee, Jack A Elias, Lloyd G Cantley, Chirag R Parikh
Deceased donor kidneys with AKI are often discarded for fear of poor transplant outcomes. Donor biomarkers that predict post-transplant renal recovery could improve organ selection and reduce discard. We tested whether higher levels of donor urinary YKL-40, a repair phase protein, associate with improved recipient outcomes in a prospective cohort study involving deceased kidney donors from five organ procurement organizations. We measured urinary YKL-40 concentration in 1301 donors (111 had AKI, defined as doubling of serum creatinine) and ascertained outcomes in the corresponding 2435 recipients, 756 of whom experienced delayed graft function (DGF)...
February 2017: Journal of the American Society of Nephrology: JASN
Dirk Jan A R Moes, Rogier R Press, Oliver Ackaert, Bart A Ploeger, Frederike J Bemelman, Cheikh Diack, Judith A M Wessels, Tahar van der Straaten, Meindert Danhof, Jan-Stephan F Sanders, Jaap J Homan van der Heide, Henk Jan Guchelaar, Johan W de Fijter
AIMS: This study aimed at identifying pharmacological factors such as pharmacogenetics and drug exposure as new predictive biomarkers for delayed graft function (DGF), acute rejection (AR) and/or subclinical rejection (SCR). METHODS: Adult renal transplant recipients (n = 361) on cyclosporine-based immunosuppression were followed for the first 6 months after transplantation. The incidence of DGF and AR were documented as well as the prevalence of SCR at 6 months in surveillance biopsies...
July 2016: British Journal of Clinical Pharmacology
Yi Liu, Hai-Xia Li, Ze-Wei Ying, Jing-Jing Guo, Chen-Ying Cao, Wang Jia, Hui-Rong Yang
BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL) can be used as an early indicator of acute kidney injury (AKI), and cystatin C is also suggested to be an ideal marker of glomerular filtration rate (GFR), but they were not sufficiently studied in recipients without delayed graft function (DGF) after living-donor kidney transplant (LDKT). The aim of the study is to investigate whether serum NGAL and cystatin C can assess the recovery of renal function after LDKT. METHODS: 49 adult patients that had undergone LDKT between January 2012 and March 2014 were prospectively enrolled...
2016: Clinical Laboratory
Tai Yeon Koo, Jong Cheol Jeong, Yonggu Lee, Kwang-Pil Ko, Kyoung-Bun Lee, Sik Lee, Suk Joo Park, Jae Berm Park, Miyeon Han, Hye Jin Lim, Curie Ahn, Jaeseok Yang
Several recipient biomarkers are reported to predict graft dysfunction, but these are not useful in decision making for the acceptance or allocation of deceased donor kidneys; thus, it is necessary to develop donor biomarkers predictive of graft dysfunction. To address this issue, we prospectively enrolled 94 deceased donors and their 109 recipients who underwent transplantation between 2010 and 2013 at 4 Korean transplantation centers. We investigated the predictive values of donor urinary neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and L-type fatty acid binding protein (L-FABP) for reduced graft function (RGF)...
March 2016: Medicine (Baltimore)
Antonio Lacquaniti, Chiara Caccamo, Paola Salis, Valeria Chirico, Antoine Buemi, Valeria Cernaro, Alberto Noto, Giuseppina Pettinato, Domenico Santoro, Tullio Bertani, Michele Buemi, Antonio David
CONTEXT: Available markers are not reliable parameters to early detect kidney injury in transplanted patients. OBJECTIVE: Examine neutrophil gelatinase associated lipocalin (NGAL) in early detection of delayed graft function (DGF) and as a long-term predictor of graft outcome. PATIENTS AND METHODS: NGAL was evaluated in 124 transplanted patients. RESULTS: Urinary NGAL levels were associated to a 10% (HR: 1.10; 95% CI: 1...
2016: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
C R Parikh, I E Hall, R S Bhangoo, J Ficek, P L Abt, H Thiessen-Philbrook, H Lin, M Bimali, P T Murray, V Rao, B Schröppel, M D Doshi, F L Weng, P P Reese
Hypothermic machine perfusion (HMP) is increasingly used in deceased donor kidney transplantation, but controversy exists regarding the value of perfusion biomarkers and pump parameters for assessing organ quality. We prospectively determined associations between perfusate biomarkers (neutrophil gelatinase-associated lipocalin [NGAL], kidney injury molecule 1, IL-18 and liver-type fatty acid-binding protein [L-FABP]) and pump parameters (resistance and flow) with outcomes of delayed graft function (DGF) and 6-mo estimated GFR (eGFR)...
May 2016: American Journal of Transplantation
Gábor Telkes, Gábor Dallos, Marina Varga
INTRODUCTION: Delayed graft function and acute rejection have negative impact on graft survival. AIM: To asses the predictive value of urinary neutrophil gelatinase-associated lipocalin, which has been found to be a promising biomarker for the diagnosis of acute kidney injury. METHOD: In this prospective study urinary neutrophil gelatinase-associated lipocalin levels of 27 kidney recipients were measured. RESULTS: Patients were grouped as follows: group 1, no complication; group 2, rejection; group 3, delayed graft function requiring dialysis; group 4, rejection plus delayed graft function...
November 29, 2015: Orvosi Hetilap
Eline Kristina van den Akker, Dennis Alexander Hesselink, Olivier Christiaan Manintveld, Jan Nicolaas Maria IJzermans, Ronald Wilhelm Frederik de Bruijn, Frank Johan Marinus Frederik Dor
BACKGROUND: No specific early biomarker is available to measure kidney injury after kidney transplantation (KT). Both neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury marker 1 (KIM-1) increase after oxidative injury. Their potential as early biomarkers was evaluated in this one-arm pilot study. MATERIALS AND METHODS: Twenty consecutive KT patients receiving a kidney from a donation after circulatory death donor were included. Graft perfusate was collected, as well as serum samples before transplantation, at the end of surgery, and 1, 4, and 7 days after transplantation...
December 2015: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
Peter P Reese, Isaac E Hall, Francis L Weng, Bernd Schröppel, Mona D Doshi, Rick D Hasz, Heather Thiessen-Philbrook, Joseph Ficek, Veena Rao, Patrick Murray, Haiqun Lin, Chirag R Parikh
Assessment of deceased-donor organ quality is integral to transplant allocation practices, but tools to more precisely measure donor kidney injury and better predict outcomes are needed. In this study, we assessed associations between injury biomarkers in deceased-donor urine and the following outcomes: donor AKI (stage 2 or greater), recipient delayed graft function (defined as dialysis in first week post-transplant), and recipient 6-month eGFR. We measured urinary concentrations of microalbumin, neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), IL-18, and liver-type fatty acid binding protein (L-FABP) from 1304 deceased donors at organ procurement, among whom 112 (9%) had AKI...
May 2016: Journal of the American Society of Nephrology: JASN
Irene Lou, David Foley, Scott K Odorico, Glen Leverson, David F Schneider, Rebecca Sippel, Herbert Chen
BACKGROUND: Most patients with end-stage renal disease will develop hyperparathyroidism (HPT). Transplantation reportedly resolves HPT in most cases. Currently, guidelines recommend a watchful waiting approach to HPT for the first 12 months after the transplantation to allow maximal allograft function. The purpose of our study is to examine the incidence and impact of HPT, defined as an elevated parathyroid hormone (PTH) level, after renal transplantation in a contemporary cohort. METHODS: Primary kidney transplantation was performed on 1609 patients from January 1, 2004, to June 6, 2012...
October 2015: Annals of Surgery
Mohammad A Amirzargar, Arsha Tafreshi Hosseini, Mahmood Gholiaf, Farahnaz Dadras, Farhad Khoshjoo
Statins are a class of drug that can efficiently reduce the level of low-density lipoprotein (LDL) as well as increase the LDL receptors. Several non-lipid-lowering effects of this type of drug have been described. It is reported that they have an influence in preventing graft rejection, especially of the acute type. In this study, patients with end-stage renal disease and candidates for kidney transplantation were divided into two groups. Group A (intervention group) received atorvastatin for two weeks prior to their transplant surgery while group B (control group) received placebo...
September 2015: Saudi Journal of Kidney Diseases and Transplantation
Nicoline V Krogstrup, Mihai Oltean, Bo M Bibby, Gertrude J Nieuwenhuijs-Moeke, Frank J M F Dor, Henrik Birn, Bente Jespersen
INTRODUCTION: Delayed graft function due to ischaemia-reperfusion injury is a frequent complication in deceased donor renal transplantation. Experimental evidence indicates that remote ischaemic conditioning (RIC) provides systemic protection against ischaemia-reperfusion injury in various tissues. METHODS AND ANALYSIS: 'Remote ischaemic conditioning in renal transplantation--effect on immediate and extended kidney graft function' (the CONTEXT study) is an investigator initiated, multicentre, randomised controlled trial investigating whether RIC of the leg of the recipient improves short and long-term graft function following deceased donor kidney transplantation...
August 20, 2015: BMJ Open
E Mamatov, A F Kocaay, M A Koc, Z K Celebi, S Sengül, K Keven, H Tutkak, A Tuzuner
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...
July 2015: Transplantation Proceedings
J Tao, X Yang, Z Han, P Lu, J Wang, X Liu, B Wu, Z Wang, Z Huang, Q Lu, R Tan, M Gu
BACKGROUND: MicroRNAs (miRNAs) are short, single-stranded, non-coding RNAs, and they are becoming increasingly known as potential biomarkers for a variety of pathologies. However, the significance of circulating miRNAs in renal transplantation patients needs further studies. MATERIALS AND METHODS: An miRNA array was used to profile the serum miRNAs of stable transplantation patients and transplantation patients with acute rejection (AR). We performed quantitative real-time polymerase chain reaction with the serum samples from 12 patients with AR, 11 control transplantation patients without rejection, and 15 transplantation patients with delayed graft function (DGF) for validation...
July 2015: Transplantation Proceedings
Lan Zhu, Gang Chen, Weijie Zhang, Hui Guo, Zhengbin Lin, Dunfeng Du, Song Chen, Huibo Shi, Shenwei Liu, Zhishui Chen
Kidney tubular damage caused by ischemia-reperfusion injury is considered the major cause of delayed graft function (DGF) after renal transplantation. It is not clear whether early generated de novo donor specific antibodies (DSA) play a role in DGF. Here, we report 2 cases of renal transplant with DGF, which seems to be associated with de novo DSA. When the early produced de novo DSA are not potent enough to mediate acute rejection, they may cause mild intra-graft injury, which has a significant impact on the degree of DGF and its recovery...
2014: Clinical Transplants
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