Associations Between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes
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 to predict allogra...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-07-01
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| Series: | Kidney International Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S246802491730061X |
| _version_ | 1818657120490356736 |
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| author | S.G. Mansour J. Puthumana P.P. Reese I.E. Hall M.D. Doshi F.L. Weng B. Schröppel H. Thiessen-Philbrook M. Bimali C.R. Parikh |
| author_facet | S.G. Mansour J. Puthumana P.P. Reese I.E. Hall M.D. Doshi F.L. Weng B. Schröppel H. Thiessen-Philbrook M. Bimali C.R. Parikh |
| author_sort | S.G. Mansour |
| collection | DOAJ |
| description | 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 to predict allograft outcomes.
Methods: We conducted a substudy of the multicenter prospective Deceased Donor Study cohort that evaluated deceased kidney donors from 5 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 glomerular filtration rate (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 donors (9%). The median (interquartile range) uMCP-1 concentration was higher in donors with AKI compared with 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 recipients (31%), but uMCP-1 was not independently associated with DGF. Higher donor uMCP-1 concentrations were independently associated with a higher 6-month eGFR in those without DGF (0.77 [0.10–1.45] ml/min per 1.73 m2 per doubling of uMCP1). However, there were no independent associations between uMCP-1 and graft failure over a median follow-up of ∼2 years. Lastly, perfusate MCP-1 concentrations significantly increased during pump perfusion but were not associated with DGF or 6-month eGFR.
Discussion: 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. |
| first_indexed | 2024-12-17T03:36:26Z |
| format | Article |
| id | doaj.art-f5fb4cdae42349bfaa7204734c5ddc0a |
| institution | Directory Open Access Journal |
| issn | 2468-0249 |
| language | English |
| last_indexed | 2024-12-17T03:36:26Z |
| publishDate | 2017-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj.art-f5fb4cdae42349bfaa7204734c5ddc0a2022-12-21T22:05:08ZengElsevierKidney International Reports2468-02492017-07-012474975810.1016/j.ekir.2017.03.007Associations Between Deceased-Donor Urine MCP-1 and Kidney Transplant OutcomesS.G. Mansour0J. Puthumana1P.P. Reese2I.E. Hall3M.D. Doshi4F.L. Weng5B. Schröppel6H. Thiessen-Philbrook7M. Bimali8C.R. Parikh9Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USAProgram of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USARenal-Electrolyte and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USADivision of Nephrology, Hypertension, and Renal Transplantation, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USADepartment of Internal Medicine, Wayne State University, Detroit, Michigan, USASaint Barnabas Medical Center, Livingston, New Jersey, USASection of Nephrology, University Hospital, Ulm, GermanyProgram of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USAProgram of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USAProgram of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USAExisting 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 to predict allograft outcomes. Methods: We conducted a substudy of the multicenter prospective Deceased Donor Study cohort that evaluated deceased kidney donors from 5 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 glomerular filtration rate (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 donors (9%). The median (interquartile range) uMCP-1 concentration was higher in donors with AKI compared with 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 recipients (31%), but uMCP-1 was not independently associated with DGF. Higher donor uMCP-1 concentrations were independently associated with a higher 6-month eGFR in those without DGF (0.77 [0.10–1.45] ml/min per 1.73 m2 per doubling of uMCP1). However, there were no independent associations between uMCP-1 and graft failure over a median follow-up of ∼2 years. Lastly, perfusate MCP-1 concentrations significantly increased during pump perfusion but were not associated with DGF or 6-month eGFR. Discussion: 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.http://www.sciencedirect.com/science/article/pii/S246802491730061XAKIdeceased donorsDGFgraft failureMCP-16-month eGFR |
| spellingShingle | S.G. Mansour J. Puthumana P.P. Reese I.E. Hall M.D. Doshi F.L. Weng B. Schröppel H. Thiessen-Philbrook M. Bimali C.R. Parikh Associations Between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes Kidney International Reports AKI deceased donors DGF graft failure MCP-1 6-month eGFR |
| title | Associations Between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes |
| title_full | Associations Between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes |
| title_fullStr | Associations Between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes |
| title_full_unstemmed | Associations Between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes |
| title_short | Associations Between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes |
| title_sort | associations between deceased donor urine mcp 1 and kidney transplant outcomes |
| topic | AKI deceased donors DGF graft failure MCP-1 6-month eGFR |
| url | http://www.sciencedirect.com/science/article/pii/S246802491730061X |
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