Abstract
Introduction: Accurate diagnostic techniques are necessary for the function assessment of deceased donor (DD) kidneys. Lipocalin-2, or neutrophil gelatinase-associated lipocalin (NGAL) is a novel biomarker of kidney injury that can be suitable in this concern.
Objectives: This study assessed the association between DDs’ serum and urine lipocalin-2 levels and graft function.
Patients and Methods: A prospective cohort study was conducted on 85 kidney transplant recipients in eight recipient hospitals who received kidneys from 44 consecutive brain-dead donors who were referred to the Iranian Tissue Bank in 2011. The serum and urine NGAL levels of donors were measured at the time of admission and before organ recovery. Recipients were followed for one year for operative and early outcome.
Results: The NGAL median level in donors’ sera whose kidneys experienced delayed graft function (DGF) in recipients was 350 ng/mL at admission and 290 ng/mL prior to organ retrieval. These figures corresponded to 340 ng/mL and 215 ng/mL in recipients with early graft function (EGF), respectively (P=0.048). In the case of donors’ urinary level of NGAL, the median was 32 ng/mL and 40 ng/mL in those whose recipients experienced DGF versus 27.5 ng/mL and 20 ng/mL in those whose recipients felt in EGF group (P=0.031). In this regard, the area under the curve (AUC) of ROC analysis was 0.63 (CI= 0.509 to 0.755); However, it could not predict DGF according to logistic regression analysis.
Conclusion: It seems that DGF is associated with increased pre-retrieval levels of sNGAL and uNGAL in brain-dead donors; nevertheless, studies with more representative samples can show more considerable statistical significance and probable predictive value.