Jafari A, Khatami M R, Dashti-Khavidaki S, Lessan-Pezeshki M, Abdollahi A
Assistant Professor of Clinical Pharmacy, Faculty of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran.
Professor of Nephrology, Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Int J Organ Transplant Med. 2017;8(1):17-27. Epub 2017 Feb 1.
Ischemic injury during organ transplantation increases the risk of acute and chronic rejections by promoting alloimmune responses. Measurement of neutrophil gelatinase-associated lipocalin (NGAL) immediately after kidney transplantation may be promising for early detection of ischemic injuries to allograft.
This study assessed possible predictive values of plasma NGAL levels during first hours after kidney transplantation for graft loss within the first 3 months after transplantation.
45 kidney transplant recipients were classified into those without graft loss or with graft loss during 3 months after transplantation. Plasma NGAL levels were measured before and at 2, 6, 12, 24 and 96 hours after transplantation. Serum creatinine concentration was assessed daily during hospitalization and at 1, 2, and 3 months post-transplantation.
Serum creatinine and plasma NGAL levels were consistently higher in patients with graft loss compared with those without graft loss. At 2, 24, and 96 hours after transplantation, plasma NGAL concentration was significantly higher in patients who developed allograft loss within 3 months post-transplantation. The cutoff point of plasma NGAL at 2, 24, and 96 hours after transplantation for prediction of graft loss was 304.5 ng/mL (sensitivity of 71.4%, and specificity of 73.7%), 207.8 ng/mL(sensitivity of 85.7%, and specificity of 60.5%), and 184 ng/mL (sensitivity of 85.7%, and specificity of 71.1%), respectively.
Plasma NGAL levels at 2, 24, and 96 hours after transplantation can predict 3-month graft loss with fair sensitivity and specificity.
器官移植期间的缺血性损伤通过促进同种免疫反应增加了急性和慢性排斥反应的风险。肾移植后立即检测中性粒细胞明胶酶相关脂质运载蛋白（NGAL）可能有助于早期发现同种异体移植物的缺血性损伤。
本研究评估肾移植后最初几小时内血浆NGAL水平对移植后3个月内移植物丢失的可能预测价值。
45例肾移植受者被分为移植后3个月内无移植物丢失或有移植物丢失的两组。在移植前以及移植后2、6、12、24和96小时测量血浆NGAL水平。住院期间每天以及移植后1、2和3个月评估血清肌酐浓度。
与无移植物丢失的患者相比，有移植物丢失的患者血清肌酐和血浆NGAL水平一直较高。在移植后2、24和96小时，移植后3个月内发生移植物丢失的患者血浆NGAL浓度显著更高。移植后2、24和96小时预测移植物丢失的血浆NGAL截断点分别为304.5 ng/mL（敏感性为71.4%，特异性为73.7%）、207.8 ng/mL（敏感性为85.7%，特异性为60.5%）和184 ng/mL（敏感性为85.7%，特异性为71.1%）。
移植后2、24和96小时的血浆NGAL水平能够以合理的敏感性和特异性预测3个月的移植物丢失。
