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Clin Transplant. 2012 Sep-Oct;26(5):775-81. doi: 10.1111/j.1399-0012.2012.01610.x. Epub 2012 Mar 8.

Neutrophil gelatinase-associated lipocalin as an early biomarker of acute kidney injury in liver transplantation.

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Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.



Acute kidney injury (AKI) is a common complication and a significant prognostic factor of long-term outcome in patients undergoing liver transplantation. We evaluated the utility of urine and plasma neutrophil gelatinase-associated lipocalin (NGAL) concentrations as biomarkers of AKI during and after liver transplantation.


We prospectively enrolled 19 adult patients who underwent living-related liver transplantation (LRLT). Serial blood and urine samples were collected at baseline and at 2, 4, 10, 16, 24, 30, 40, and 48 h after reperfusion, and their concentrations of NGAL were measured, with urinary NGAL corrected by urinary creatinine concentration to compensate for urine output. AKI was defined by Risk-Injury-Failure-Loss-End-stage kidney disease (RIFLE) criteria as a ≥50% increase in serum creatinine from baseline.


Eleven of 19 patients were diagnosed with AKI according to RIFLE criteria. Urinary NGAL/urine creatinine ratio increased immediately after reperfusion and peaked four h later and preceded a ≥50% elevation in serum Cr by 19.0 h (p = 0.001). Plasma NGAL also tended to be elevated 13.0 h earlier than serum creatinine (p = 0.075).


The urinary NGAL/urine creatinine ratio may be an early biomarker of AKI in adult patients undergoing LRLT.

[Indexed for MEDLINE]

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