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Serum liver‐type fatty acid‐binding protein predicts recovery of graft function after kidney transplantation from donors after cardiac death
Author(s) -
Kawai Akihiro,
Kusaka Mamoru,
Kitagawa Fumihiko,
Ishii Junichi,
Fukami Naohiko,
Maruyama Takahiro,
Sasaki Hitomi,
Shiroki Ryoichi,
Kurahashi Hiroki,
Hoshinaga Kiyotaka
Publication year - 2014
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12375
Subject(s) - medicine , urology , transplantation , receiver operating characteristic , renal function , creatinine , urinary system , kidney transplantation , biomarker , liver transplantation , gastroenterology , hemodialysis , kidney , heart type fatty acid binding protein , cardiology , endocrinology , fatty acid binding protein , biochemistry , chemistry , gene
Kidneys procured by donation after cardiac death ( DCD ) may increase the donor pool but are associated with high incidence of delayed graft function ( DGF ). Urinary liver‐type fatty acid‐binding protein ( L ‐ FABP ) level is an early biomarker of renal injury after kidney transplantation ( KT x); however, its utility is limited in DGF cases owing to urine sample unavailability. We examined whether serum L ‐ FABP level predicts functional recovery of transplanted DCD kidneys. Consecutive patients undergoing KT x from living related donors ( LD ), brain‐dead donors ( BD ), or DCD were retrospectively enrolled. Serum L ‐ FABP levels were measured from samples collected before and after KT x. Serum L ‐ FABP decreased rapidly in patients with immediate function, slowly in DGF patients, and somewhat increased in DGF patients requiring hemodialysis ( HD ) for >1 wk. Receiver‐operating characteristic curve analysis demonstrated that DGF was predicted with 84% sensitivity ( SE ) and 86% specificity ( SP ) at cutoff of 9.0 ng/mL on post‐operative day ( POD ) 1 and 68% SE and 90% SP at 6.0 on POD 2. DGF >7 d was predicted with 83% SE and 78% SP at 11.0 on POD 1 and 67% SE and 78% SP at 6.5 on POD 2. Serum L ‐ FABP levels may predict graft recovery and need for HD after DCD KT x.