Ye Yongrong, Han Fei, Ma Maolin, Sun Qipeng, Huang Zhengyu, Zheng Haofeng, Yang Zhe, Luo Zihuan, Liao Tao, Li Heng, Hong Liangqing, Na Ning, Sun Qiquan
Division of Kidney Transplantation, Organ Transplantation Research Institution, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Kidney Transplantation, Guangdong Provincial People's Hospital, Guangzhou, China.
Front Med (Lausanne). 2021 Sep 1;8:708316. doi: 10.3389/fmed.2021.708316. eCollection 2021.
Delayed graft function (DGF) is a common complication after kidney transplantation (KT) with a poor clinical outcome. There are no accurate biomarkers for the early prediction of DGF. Macrophage migration inhibitory factor (MIF) release during surgery plays a key role in protecting the kidney, and may be a potential biomarker for predicting post-transplant renal allograft recovery. Recipients who underwent KT between July 2020 and December 2020 were enrolled in the study. Plasma MIF levels were tested in recipients at different time points, and the correlation between plasma MIF and DGF in recipients was evaluated. This study was registered in the Chinese Clinical Trial Registry (ChiCTR2000035596). Intraoperative MIF levels were different between immediate, slowed, and delayed graft function groups (7.26 vs. 6.49 and 5.59, < 0.001). Plasma MIF was an independent protective factor of DGF (odds ratio = 0.447, 95% confidence interval [CI] 0.264-0.754, = 0.003). Combining plasma MIF level and donor terminal serum creatinine provided the best predictive power for DGF (0.872; 95%CI 0.795-0.949). Furthermore, plasma MIF was significantly associated with allograft function at 1-month post-transplant ( = 0.42, < 0.001). Intraoperative MIF, as an independent protective factor for DGF, has excellent diagnostic performance for predicting DGF and is worthy of further exploration.
移植肾功能延迟恢复（DGF）是肾移植（KT）后常见的并发症，临床预后较差。目前尚无准确的生物标志物可用于早期预测DGF。手术过程中巨噬细胞移动抑制因子（MIF）的释放对肾脏保护起关键作用，可能是预测移植后肾移植恢复的潜在生物标志物。本研究纳入了2020年7月至2020年12月期间接受KT的受者。在不同时间点检测受者血浆MIF水平，并评估受者血浆MIF与DGF之间的相关性。本研究已在中国临床试验注册中心注册（ChiCTR2000035596）。即时、缓慢和延迟移植肾功能组的术中MIF水平存在差异（7.26对6.49和5.59，<0.001）。血浆MIF是DGF的独立保护因素（比值比=0.447，95%置信区间[CI]0.264-0.754，=0.003）。结合血浆MIF水平和供体终末期血清肌酐对DGF具有最佳预测能力（0.872；95%CI 0.795-0.949）。此外，血浆MIF与移植后1个月时的移植肾功能显著相关（=0.42，<0.001）。术中MIF作为DGF的独立保护因素，对预测DGF具有优异的诊断性能，值得进一步探索。
