Department of Surgery and Interventional Science, Royal Free Campus, University College London, 9th Floor Royal Free London NHS Foundation Trust, Pond Street, NW3 2QG, UK.
Department of Surgery and Interventional Science, Royal Free Campus, University College London, 9th Floor Royal Free London NHS Foundation Trust, Pond Street, NW3 2QG, UK.
Int J Surg. 2018 Nov;59:48-54. doi: 10.1016/j.ijsu.2018.09.003. Epub 2018 Sep 28.
Acute kidney injury (AKI) is common after orthotopic liver transplantation (OLT) usually occurring early post-transplant. Multiple causes include graft preservation injury, blood loss, hypotension but also severity of recipient liver disease. Early intervention in AKI has both short and long term patient benefits. Unfortunately there are no current clinical biomarkers of early AKI.
To assess the value of NGAL in predicting AKI following OLT.
Ovid MEDLINE and EMBASE were searched between the years of 2000 and 2017 for studies using keywords: Neutrophil Gelatinase Associated Lipocalin or NGAL variants combined with synonyms for liver transplantation.
96 studies were identified. 11 studies including 563 patients were considered suitable for analysis. Both urinary (uNGAL) and plasma NGAL (pNGAL) measurement were found to predict AKI after liver transplantation. Optimal reported area under the receiver-operator characteristics curve (AUROC) values of 0.5-0.83 and 0.54-0.86 respectively.
NGAL is a good predictor of early AKI post OLT although there is considerable variation in the published results. Further studies with prospectively defined cut-off values, standardized definitions of AKI and rigorous data reporting should be conducted to establish its clinical usefulness and limitations.
肝移植术后（OLT）常发生急性肾损伤（AKI），通常发生在移植后早期。多种原因包括供体保存损伤、失血、低血压，但也包括受体肝病的严重程度。AKI 的早期干预具有短期和长期的患者获益。不幸的是，目前没有 AKI 的临床生物标志物。
评估中性粒细胞明胶酶相关脂质运载蛋白（NGAL）在预测 OLT 后 AKI 中的价值。
在 2000 年至 2017 年期间，使用关键词：中性粒细胞明胶酶相关脂质运载蛋白或 NGAL 变体结合肝移植的同义词，在 Ovid MEDLINE 和 EMBASE 上搜索研究。
确定了 96 项研究。11 项研究包括 563 例患者被认为适合分析。尿（uNGAL）和血浆 NGAL（pNGAL）测量均能预测肝移植后的 AKI。报告的最佳受试者工作特征曲线（AUROC）值分别为 0.5-0.83 和 0.54-0.86。
NGAL 是 OLT 后早期 AKI 的良好预测指标，尽管发表的结果存在很大差异。应进行具有前瞻性定义的截断值、AKI 的标准化定义和严格的数据报告的进一步研究，以确定其临床用途和局限性。
