Postoperative Neutrophil to Lymphocyte and Platelet Ratio and Delayed Graft Function
Introduction: Delayed graft function (DGF), an outcome for which inflammation is critical, has been associated with worse outcomes after kidney transplantation (KT). The neutrophil to lymphocyte and platelet (NLP) ratio is a biomarker of systemic inflammation. We assessed postoperative NLP ratio a...
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| Format: | Article |
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Publicações Ciência e Vida
2023-12-01
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| Series: | Revista Portuguesa de Nefrologia e Hipertensão |
| Subjects: | |
| Online Access: | https://spnefro.pt/_doi/reference/002784e2-2023-40a2-bdf7-9c8f7429387a |
| _version_ | 1797341764810440704 |
|---|---|
| author | João Oliveira João Missa Joana Gameiro Alice Santana José António Lopes Marta Neves |
| author_facet | João Oliveira João Missa Joana Gameiro Alice Santana José António Lopes Marta Neves |
| author_sort | João Oliveira |
| collection | DOAJ |
| description | Introduction: Delayed graft function (DGF), an outcome for which inflammation is critical, has been associated with worse outcomes after
kidney transplantation (KT). The neutrophil to lymphocyte and platelet (NLP) ratio is a biomarker of systemic inflammation. We assessed
postoperative NLP ratio applicability as an early predictor of DGF in KT patients.
Methods: Retrospective cohort of adult patients submitted to KT at our unit, between 1 January 2010 and 31 December 2020. NLP was
calculated at 24 hours post-KT. Primary outcome was development of DGF. Logistic regression was calculated to determine significant factors
which may have contributed to DGF.
Results: We included 527 patients with a mean age of 49.9 ± 12.8 years. In 47.8% of patients expanded criteria donors were used, and in
3.6% non-heart-beating donors. DGF occurred in 17.8% of patients. Mean post-KT NLP was higher in patients submitted to induction therapy
with lymphocyte depleting antibodies (50.2±40.3 vs 11.9±7.4 with basiliximab, p<0.001), but it was found to be higher even before KT (5.2±1.8
vs 1.9±1.2, p=0.001). Grafts from non-heart-beating donors (OR 13.989, 95% CI 4.741, 41.274, p=0.000), longer warm ischemia time (OR 1.035,
95% CI 1.007, 1.064, p=0.014) and higher NLP ratio 24 hours after transplantation (OR 1.009, 95% CI 1.002, 1.016, p=0.015) were independently
associated with DGF.
Conclusion: Higher NLP ratio at 24 hours after KT was independently associated with DGF. This reflects the impact of inflammation on KT
outcomes and highlights the role of the NLP ratio as a sensitive marker of systemic inflammatory response after KT. |
| first_indexed | 2024-03-08T10:23:51Z |
| format | Article |
| id | doaj.art-965bfd394d284feda873b53a1cb015e1 |
| institution | Directory Open Access Journal |
| issn | 0872-0169 2183-1289 |
| language | English |
| last_indexed | 2024-03-08T10:23:51Z |
| publishDate | 2023-12-01 |
| publisher | Publicações Ciência e Vida |
| record_format | Article |
| series | Revista Portuguesa de Nefrologia e Hipertensão |
| spelling | doaj.art-965bfd394d284feda873b53a1cb015e12024-01-27T11:04:36ZengPublicações Ciência e VidaRevista Portuguesa de Nefrologia e Hipertensão0872-01692183-12892023-12-0137418519110.32932/pjnh.2023.11.261Postoperative Neutrophil to Lymphocyte and Platelet Ratio and Delayed Graft FunctionJoão Oliveira0https://orcid.org/0000-0001-5097-9630João Missa1Joana Gameiro2 Alice Santana3José António Lopes4Marta Neves51 Nephrology and Renal Transplantation Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, PortugalClínica Universitária de Nefrologia, Faculdade de Medicina da Universidade de Lisboa, Lisbon, PortugalNephrology and Renal Transplantation Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, PortugalNephrology and Renal Transplantation Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, PortugalNephrology and Renal Transplantation Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, PortugalNephrology and Renal Transplantation Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, PortugalIntroduction: Delayed graft function (DGF), an outcome for which inflammation is critical, has been associated with worse outcomes after kidney transplantation (KT). The neutrophil to lymphocyte and platelet (NLP) ratio is a biomarker of systemic inflammation. We assessed postoperative NLP ratio applicability as an early predictor of DGF in KT patients. Methods: Retrospective cohort of adult patients submitted to KT at our unit, between 1 January 2010 and 31 December 2020. NLP was calculated at 24 hours post-KT. Primary outcome was development of DGF. Logistic regression was calculated to determine significant factors which may have contributed to DGF. Results: We included 527 patients with a mean age of 49.9 ± 12.8 years. In 47.8% of patients expanded criteria donors were used, and in 3.6% non-heart-beating donors. DGF occurred in 17.8% of patients. Mean post-KT NLP was higher in patients submitted to induction therapy with lymphocyte depleting antibodies (50.2±40.3 vs 11.9±7.4 with basiliximab, p<0.001), but it was found to be higher even before KT (5.2±1.8 vs 1.9±1.2, p=0.001). Grafts from non-heart-beating donors (OR 13.989, 95% CI 4.741, 41.274, p=0.000), longer warm ischemia time (OR 1.035, 95% CI 1.007, 1.064, p=0.014) and higher NLP ratio 24 hours after transplantation (OR 1.009, 95% CI 1.002, 1.016, p=0.015) were independently associated with DGF. Conclusion: Higher NLP ratio at 24 hours after KT was independently associated with DGF. This reflects the impact of inflammation on KT outcomes and highlights the role of the NLP ratio as a sensitive marker of systemic inflammatory response after KT.https://spnefro.pt/_doi/reference/002784e2-2023-40a2-bdf7-9c8f7429387ablood plateletsdelayed graft functionlymphocyteskidney transplantationblood platelet |
| spellingShingle | João Oliveira João Missa Joana Gameiro Alice Santana José António Lopes Marta Neves Postoperative Neutrophil to Lymphocyte and Platelet Ratio and Delayed Graft Function Revista Portuguesa de Nefrologia e Hipertensão blood platelets delayed graft function lymphocytes kidney transplantation blood platelet |
| title | Postoperative Neutrophil to Lymphocyte and Platelet Ratio and Delayed Graft Function |
| title_full | Postoperative Neutrophil to Lymphocyte and Platelet Ratio and Delayed Graft Function |
| title_fullStr | Postoperative Neutrophil to Lymphocyte and Platelet Ratio and Delayed Graft Function |
| title_full_unstemmed | Postoperative Neutrophil to Lymphocyte and Platelet Ratio and Delayed Graft Function |
| title_short | Postoperative Neutrophil to Lymphocyte and Platelet Ratio and Delayed Graft Function |
| title_sort | postoperative neutrophil to lymphocyte and platelet ratio and delayed graft function |
| topic | blood platelets delayed graft function lymphocytes kidney transplantation blood platelet |
| url | https://spnefro.pt/_doi/reference/002784e2-2023-40a2-bdf7-9c8f7429387a |
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