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Mitochondrial membrane potential and delayed graft function following kidney transplantation
Author(s) -
GaronzikWang Jacqueline M.,
Lonze Bonnie E.,
Ruck Jessica M.,
Luo Xun,
Massie Allan B.,
Melancon Keith,
Burdick James F.,
Segev Dorry L.,
Sun Zhaoli
Publication year - 2019
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.15174
Subject(s) - medicine , transplantation , odds ratio , kidney transplantation , urology , kidney , surrogate endpoint , surgery
Delayed graft function ( DGF ) complicates 20%‐40% of deceased‐donor kidney transplants and is associated with increased length of stay and subsequent allograft failure. Accurate prediction of DGF risk for a particular allograft could influence organ allocation, patient counseling, and postoperative planning. Mitochondrial dysfunction, a reported surrogate of tissue health in ischemia‐perfusion injury, might also be a surrogate for tissue health after organ transplantation. To understand the potential of mitochondrial membrane potential ( MMP ) in clinical decision‐making, we analyzed whether lower MMP , a measure of mitochondrial dysfunction, was associated with DGF . In a prospective, single‐center proof‐of‐concept study, we measured pretransplant MMP in 28 deceased donor kidneys and analyzed the association between MMP and DGF . We used hybrid registry‐augmented regression to adjust for donor and recipient characteristics, minimizing overfitting by leveraging Scientific Registry of Transplant Recipients data. The range of MMP levels was 964‐28 333 units. Low‐ MMP kidneys ( MMP <4000) were more likely from female donors (75% vs 10%, P = .002) and donation after cardiac death donors (75% vs 12%, P = .004). For every 10% decrease in MMP levels, there were 38% higher odds of DGF (adjusted odds ratio = 1.08 1.38 1.78 , P = .01). In summary, MMP might be a promising pretransplant surrogate for tissue health in kidney transplantation and, after further validation, could improve clinical decision‐making through its independent association with DGF .