BACKGROUND: Inflammation plays an important role in the pathogenesis of ischemic acute kidney injury (IAKI). In this study, we hypothesize that transplant recipients with pretransplant inflammation may have a greater chance of developing delayed graft function (DGF), an example of IAKI. PATIENTS AND METHODS: We analyzed 178 patients who had undergone their first transplant using cadaveric donors. Blood samples were extracted from transplant recipients prior to transplantation. C-reactive protein (CRP) (nephelometry); interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) (automatized enzyme chemiluminescence immunometric assay); and pregnancy-associated plasma protein A (PAPP-A) (enzyme-linked immunosorbent assay) were determined using the pretransplant blood samples. The risk factors analyzed included cold ischemia, type and time of dialysis, donor and recipient age and HLA compatibility. RESULTS: Sixty-one patients (34.3%) developed DGF. Pretransplant TNF-alpha (9.31 +/- 2.57 vs. 10.56 +/- 3.82 pg/mL; p=0.039) and PAPP-A (1.25 +/- 0.74 vs. 1.90 +/- 1.56 mU/L; p=0.002) were significantly elevated in the group of patients with DGF. Univariate analysis showed that PAPP-A, TNF-alpha, cold ischemia, type of dialysis (hemodialysis) and donor age were associated with DGF. Multivariate analysis showed that PAPP-A (p=0.006), cold ischemia (p=0.009) and type of dialysis (p=0.046) were independent risk factors for DGF. CONCLUSIONS: Pretransplant inflammation (TNF-alpha, PAPP-A) in transplant recipients could be a risk factor for the development of DGF.
BACKGROUND:Inflammation plays an important role in the pathogenesis of ischemic acute kidney injury (IAKI). In this study, we hypothesize that transplant recipients with pretransplant inflammation may have a greater chance of developing delayed graft function (DGF), an example of IAKI. PATIENTS AND METHODS: We analyzed 178 patients who had undergone their first transplant using cadaveric donors. Blood samples were extracted from transplant recipients prior to transplantation. C-reactive protein (CRP) (nephelometry); interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) (automatized enzyme chemiluminescence immunometric assay); and pregnancy-associated plasma protein A (PAPP-A) (enzyme-linked immunosorbent assay) were determined using the pretransplant blood samples. The risk factors analyzed included cold ischemia, type and time of dialysis, donor and recipient age and HLA compatibility. RESULTS: Sixty-one patients (34.3%) developed DGF. Pretransplant TNF-alpha (9.31 +/- 2.57 vs. 10.56 +/- 3.82 pg/mL; p=0.039) and PAPP-A (1.25 +/- 0.74 vs. 1.90 +/- 1.56 mU/L; p=0.002) were significantly elevated in the group of patients with DGF. Univariate analysis showed that PAPP-A, TNF-alpha, cold ischemia, type of dialysis (hemodialysis) and donor age were associated with DGF. Multivariate analysis showed that PAPP-A (p=0.006), cold ischemia (p=0.009) and type of dialysis (p=0.046) were independent risk factors for DGF. CONCLUSIONS: Pretransplant inflammation (TNF-alpha, PAPP-A) in transplant recipients could be a risk factor for the development of DGF.
Authors: Antonio J López-Farré; Juana María Santos-Sancho; Javier Modrego; Antonio Segura; José J Zamorano-León; Leyre Martín; Ana Sánchez-Fructuoso; Pablo Rodríguez-Sierra; Fernando Prados; Alonso Mateos; José Herrero; Francisco del Río; Alberto Barrientos Journal: J Nephrol Date: 2015-05-14 Impact factor: 3.902
Authors: Juan S Danobeitia; Tiffany J Zens; Peter J Chlebeck; Laura J Zitur; Jose A Reyes; Michael J Eerhart; Jennifer Coonen; Saverio Capuano; Anthony M D'Alessandro; Jose R Torrealba; Daniel Burguete; Kevin Brunner; Edwin Van Amersfoort; Yolanda Ponstein; Cees Van Kooten; Ewa Jankowska-Gan; William Burlingham; Jeremy Sullivan; Arjang Djamali; Myron Pozniak; Yucel Yankol; Luis A Fernandez Journal: Am J Transplant Date: 2020-02-20 Impact factor: 8.086
Authors: Yijing Feng; Miranda R Jones; JiYoon B Ahn; Jacqueline M Garonzik-Wang; Dorry L Segev; Mara McAdams-DeMarco Journal: Am J Transplant Date: 2021-05-20 Impact factor: 9.369
Authors: Richard Dumbill; Roderick Jaques; Matthew Robb; Rachel Johnson; Rutger J Ploeg; Maria E Kaisar; Edward J Sharples Journal: J Clin Med Date: 2022-04-15 Impact factor: 4.964