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Kidney Int Rep. 2017 Jul;2(4):749-758. doi: 10.1016/j.ekir.2017.03.007. Epub 2017 Mar 31.

Associations between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes.

Author information

1
Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT.
2
Section of Nephrology, Yale University School of Medicine, New Haven, CT.
3
Renal-Electrolyte and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
4
Division of Nephrology, Hypertension and Renal Transplantation, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT.
5
Wayne State University, Detroit, MI.
6
Saint Barnabas Medical Center, Livingston, NJ.
7
Section of Nephrology, University Hospital, Ulm, Germany.
8
Veterans Affairs Connecticut Healthcare System, New Haven, CT.

Abstract

INTRODUCTION:

Existing methods to predict recipient allograft function during deceased-donor kidney procurement are imprecise. Understanding the potential renal reparative role for monocyte chemoattractant protein-1 (MCP-1), a cytokine involved in macrophage recruitment after injury, might help predict allograft outcomes.

METHODS:

We conducted a sub-study of the multicenter prospective Deceased Donor Study cohort, which evaluated deceased kidney donors from five organ procurement organizations from May 2010 to December 2013. We measured urine MCP-1 (uMCP-1) concentrations from donor samples collected at nephrectomy to determine associations with donor acute kidney injury (AKI), recipient delayed graft function (DGF), 6-month estimated GFR (eGFR), and graft failure. We also assessed perfusate MCP-1 concentrations from pumped kidneys for associations with DGF and 6-month eGFR.

RESULTS:

AKI occurred in 111 (9%) donors. Median (interquartile range) uMCP-1 concentration was higher in donors with AKI compared to donors without AKI (1.35 [0.41-3.93] ng/ml vs. 0.32 [0.11-0.80] ng/ml, p<0.001). DGF occurred in 756 (31%) recipients, but uMCP-1 was not independently associated with DGF. Higher donor uMCP-1 concentrations were independently associated with higher 6-month eGFR in those without DGF [0.77 (0.10, 1.45) ml/min/1.73m2 per doubling of uMCP1]. However, there were no independent associations between uMCP-1 and graft failure over a median follow-up of about 2 years. Lastly, perfusate MCP-1 concentrations significantly increased during pump perfusion but were not associated with DGF or 6-month eGFR.

CONCLUSION:

Donor uMCP-1 concentrations were modestly associated with higher recipient 6-month eGFR in those without DGF. However, the results suggest that donor uMCP-1 has minimal clinical utility given no associations with graft failure.

KEYWORDS:

6-month eGFR; AKI; DGF; Graft failure; MCP-1; deceased donors; recipient outcomes

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