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J Am Coll Surg. 2010 Nov;211(5):587-95. doi: 10.1016/j.jamcollsurg.2010.06.391. Epub 2010 Sep 15.

Clinical evidence of the association between serum perioperative changes in xanthine metabolizing enzymes activity and early post-transplant kidney allograft function.

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1
Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland.

Abstract

BACKGROUND:

Xanthine oxidoreductase (XOR) and its active forms, dehydrogenase (XD) and oxidase (XO), act as double-edged swords during ischemia-reperfusion injury. On the one hand, their action generates antioxidants, such as uric acid (UA); however, they may strongly enhance production of free radicals. In this study, we examined the association between post-transplant graft function and perioperative xanthine metabolizing enzymes (XME) activity in kidney transplant recipients divided into early (EGF), slow (SGF), and delayed graft function (DGF) groups.

STUDY DESIGN:

XME activity and UA levels were measured in blood samples collected directly before and during the first and fifth minutes of reperfusion.

RESULTS:

Results demonstrated an increase in XO and XOR activity in all groups; however, these parameters were lower in the EGF than in the DGF group (p < 0.005; p < 0.05). XD activity increased in SGF and DGF patients (p = 0.01); nevertheless, the XD/total XOR coefficient decreased only in DGF individuals (p = 0.0007). XME sensitivity, specificity, and positive and negative predictive values in discriminating SGF/DGF from EGF were 73.3% to 78%, 54% to 62.5%, 76% to 78.6%, and 56.5%, respectively. Moreover, mixed model analysis revealed that recipients classified according to results of XOR(5) and XO(5) significantly differ in 1-year post-transplant allograft function (p = 0.04 and p = 0.02, respectively), but not in the frequency of acute rejection episodes (p = 0.66 and p = 0.90, respectively).

CONCLUSIONS:

During renal transplantation, significant changes in XME occur that are associated with early post-transplant graft function and have potential value to discern between EGF and SGF/DGF.

[Indexed for MEDLINE]

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