BACKGROUND: Urinary neutrophil gelatinase-associated lipocalin (NGAL) is a novel, sensitive and specific biomarker that is rapidly released after kidney injury. It predicts acute kidney injury (AKI) in multiple clinical scenarios. We hypothesized that urinary NGAL can predict AKI after liver transplantation. METHODS: Urine was collected in 92 patients undergoing liver transplantation (18 living-related and 74 deceased) before surgery, after reperfusion of the liver graft and then 3, 18 and 24 h later. NGAL was analyzed with enzyme-linked immunosorbent assay and corrected for dilution/concentration by calculating urinary NGAL/urine creatinine ratios. AKI was defined by Risk-Injury-Failure-Loss-Endstage stage kidney disease (RIFLE)-risk criteria (increase of serum creatinine by >50%). RESULTS: Urinary NGAL/urine creatinine ratio was low prior to surgery and increased immediately after reperfusion, peaked 3 h later and remained elevated at 18 and 24 h. Urinary NGAL/urine creatinine ratios were higher in patients with post-operative (post-OP) AKI defined by RIFLE--risk criteria 3 and 18 h after reperfusion. The area under the curve of the receiver operator characteristics curve of urinary NGAL/urine creatinine ratio to predict AKI was 0.800 (95% CI: 0.732-0.869, P < 0.0001) 3 h and 0.636 (95% CI: 0.551-0.720, P < 0.005) 18 h after reperfusion. CONCLUSIONS: We conclude that urinary NGAL/urine creatinine ratio is able to predict post-OP AKI 3 and 18 h after transplantation with good discrimination.
BACKGROUND: Urinary neutrophil gelatinase-associated lipocalin (NGAL) is a novel, sensitive and specific biomarker that is rapidly released after kidney injury. It predicts acute kidney injury (AKI) in multiple clinical scenarios. We hypothesized that urinary NGAL can predict AKI after liver transplantation. METHODS: Urine was collected in 92 patients undergoing liver transplantation (18 living-related and 74 deceased) before surgery, after reperfusion of the liver graft and then 3, 18 and 24 h later. NGAL was analyzed with enzyme-linked immunosorbent assay and corrected for dilution/concentration by calculating urinary NGAL/urine creatinine ratios. AKI was defined by Risk-Injury-Failure-Loss-Endstage stage kidney disease (RIFLE)-risk criteria (increase of serum creatinine by >50%). RESULTS: Urinary NGAL/urine creatinine ratio was low prior to surgery and increased immediately after reperfusion, peaked 3 h later and remained elevated at 18 and 24 h. Urinary NGAL/urine creatinine ratios were higher in patients with post-operative (post-OP) AKI defined by RIFLE--risk criteria 3 and 18 h after reperfusion. The area under the curve of the receiver operator characteristics curve of urinary NGAL/urine creatinine ratio to predict AKI was 0.800 (95% CI: 0.732-0.869, P < 0.0001) 3 h and 0.636 (95% CI: 0.551-0.720, P < 0.005) 18 h after reperfusion. CONCLUSIONS: We conclude that urinary NGAL/urine creatinine ratio is able to predict post-OP AKI 3 and 18 h after transplantation with good discrimination.
Authors: Claus U Niemann; Ann Walia; Jeffrey Waldman; Michael Davio; John P Roberts; Ryutaro Hirose; John Feiner Journal: Liver Transpl Date: 2009-12 Impact factor: 5.799
Authors: Yousri M Barri; Edmund Q Sanchez; Linda W Jennings; Larry B Melton; Steven Hays; Marlon F Levy; Goran B Klintmalm Journal: Liver Transpl Date: 2009-05 Impact factor: 5.799
Authors: Peter Rosenberger; Jan M Schwab; Valbona Mirakaj; Eva Masekowsky; Alice Mager; Julio C Morote-Garcia; Klaus Unertl; Holger K Eltzschig Journal: Nat Immunol Date: 2009-01-04 Impact factor: 25.606
Authors: Derek S Wheeler; Prasad Devarajan; Qing Ma; Kelli Harmon; Marie Monaco; Natalie Cvijanovich; Hector R Wong Journal: Crit Care Med Date: 2008-04 Impact factor: 7.598
Authors: Catherine L Dent; Qing Ma; Sudha Dastrala; Michael Bennett; Mark M Mitsnefes; Jonathan Barasch; Prasad Devarajan Journal: Crit Care Date: 2007 Impact factor: 9.097
Authors: Luís Taddeo Filho; Antonio Jose Grande; Tamy Colonetti; Éverton Simon Possamai Della; Maria Inês da Rosa Journal: Pediatr Nephrol Date: 2017-06-14 Impact factor: 3.714
Authors: Giuseppe Cullaro; Joseph F Pisa; Robert S Brown; Gebhard Wagener; Elizabeth C Verna Journal: Transplantation Date: 2018-05 Impact factor: 4.939
Authors: Justin M Belcher; Guadalupe Garcia-Tsao; Arun J Sanyal; Heather Thiessen-Philbrook; Aldo J Peixoto; Mark A Perazella; Naheed Ansari; Joseph Lim; Steven G Coca; Chirag R Parikh Journal: Clin J Am Soc Nephrol Date: 2014-09-02 Impact factor: 8.237