Abstract: TH-PO1115
Increased Delta Neutrophil Index Is Associated with Poor Prognosis in Cadaveric Donor Kidney Transplantation
Session Information
- Transplantation: Clinical - Predictors of Outcomes - Biomarkers and Beyond
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Yang, Jae Won, Wonju Christian Severance Hospital, Wonju, Kangwon do, Korea (the Republic of)
- Lee, Jun Young, Wonju Christian Severance Hospital, Wonju, Kangwon do, Korea (the Republic of)
- Kim, Jae seok, Wonju Christian Severance Hospital, Wonju, Kangwon do, Korea (the Republic of)
- Chai, Moonhee, Wonju Christian Severance Hospital, Wonju, Kangwon do, Korea (the Republic of)
- Eom, Minseob, Yonsei Univ. Wonju College of Medicine, Wonju, Korea (the Republic of)
- Choi, Seung-Ok, Wonju Christian Severance Hospital, Wonju, Kangwon do, Korea (the Republic of)
- Jeong, Jin-Jae, Wonju Christian Severance Hospital, Wonju, Kangwon do, Korea (the Republic of)
Background
Delta Neutrophil Index (DNI) is the fraction of circulating immature granulocytes. In many studies, DNI has been demonstrated as a useful prognostic marker in critical patients. We hypothesized that increased level of DNI in the recipient is associated with poor prognosis in cadaveric donor renal transplantation (CRT).
Methods
We reviewed medical records of a total of 73 patients undergoing CRT from March 2013 to January 2018 retrospectively. The transplant rejection (TR) was assessed using Banff classification, and subclinical rejection was excluded in the study.
Results
Twenty-five (34.2%) patients were diagnosed with TR. Among them, 11 patients were classified as early TR. The post-operative DNI (po-DNI) was higher in the patients with early TR than that of patients without it (1.21 vs. 0.18, p<0.001). In univariate logistic regression test, cold ischemic time, last creatinine level of the donor before transplantation (last-Cr), po-DNI level, and peri-operative infection predicted early TR. In multivariate-adjusted logistic regression test, only high level of po-DNI predicted early TR (Odds ratio 12.31, 95% CI 1.22-129.82, p=0.034). The c-statistic value of po-DNI in the logistic model was 0.78 (95% CI 0.60-0.95, p=0.004). Multivariate Cox regression analysis showed that last-Cr (Hazard ratio (HR) 2.25, 95% CI 1.26-4.13, p=0.006) and pre-operative DNI (HR 14.02, 95% CI 2.62-75.26, p=0.002) predict renal survival in CRT.
Conclusion
Increased DNI of the recipient in CRT is thought to be a useful marker for predicting early TR and renal survival.
Cumulative early acute rejection free period according to DNI level