Gok Muhammed A, Pelzers Maurice, Glatz Jan F C, Shenton Brian K, Buckley Pamela E, Peaston Robert, Cornell Chris, Mantle Dave, Soomro Naeem, Jaques Bryon C, Manas Derek M, Talbot David
Renal/Liver Transplant Unit, The Freeman Hospital, University of Newcastle Upon Tyne, Level 5, NE7 7DN, Newcastle Upon Tyne, England, UK.
Clin Chim Acta. 2003 Dec;338(1-2):33-43. doi: 10.1016/j.cccn.2003.07.023.
Renal transplantation in many units is limited by the availability of donor organs. Kidneys obtained from non-heart-beating donors (NHBD) represent an important resource, with the potential to substantially increase the available donor organ pool. Such kidneys are associated with increased warm ischaemic tissue injury which may be assessed by hypothermic machine perfusion. Within our transplant centre, a key component of such damage assessment and viability screening involves the quantification of the tissue damage biomarkers glutathione S-transferase in kidney perfusates.
Since 1998, 126 NHBD kidneys were machine-perfused prior to implantation, resulting in 74 transplants. Kidney perfusate samples were assayed for glutathione S-transferase in "real time", and alanine aminopeptidase and fatty acid binding protein in "retrospect".
The pre-transplant concentration of these tissue injury biomarkers determined pre-transplant did not correlate with subsequent longer-term renal function, as assessed by measurement of serum creatinine (tGST: Spearman correlation r=-0.02; Ala-AP: r=0.02; H-FABP: r=-0.05) and creatinine clearance (tGST: r=0.08; Ala-AP: r=-0.02; H-FABP: r=0.14) for those kidneys that had passed their viability tests.
Thus whilst these biomarkers may represent reliable pre-transplant indicators of immediate kidney viability and short-term kidney function, they do not predict the efficacy of renal function in the longer term.
许多单位的肾移植受供体器官可用性的限制。从非心脏骤停供体（NHBD）获取的肾脏是一种重要资源，有可能大幅增加可用的供体器官库。此类肾脏与热缺血性组织损伤增加相关，可通过低温机器灌注进行评估。在我们的移植中心，这种损伤评估和活力筛查的一个关键组成部分涉及对肾脏灌注液中组织损伤生物标志物谷胱甘肽S-转移酶进行定量。
自1998年以来，126个NHBD肾脏在植入前进行了机器灌注，74个成功移植。肾脏灌注液样本实时检测谷胱甘肽S-转移酶，并回顾性检测丙氨酸氨基肽酶和脂肪酸结合蛋白。
对于通过活力测试的肾脏，移植前测定的这些组织损伤生物标志物的移植前浓度与随后的长期肾功能不相关，通过测量血清肌酐（tGST：Spearman相关系数r = -0.02；Ala-AP：r = 0.02；H-FABP：r = -0.05）和肌酐清除率（tGST：r = 0.08；Ala-AP：r = -0.02；H-FABP：r = 0.14）评估。
因此，虽然这些生物标志物可能是移植前即时肾脏活力和短期肾功能的可靠指标，但它们不能预测长期肾功能的疗效。
