Kidney Week

Abstract: TH-PO1104

Urinary Biomarkers TIMP-2 and IGFBP7 Are Predictive for Recovery from Ischemia-Reperfusion Injury After 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

• Eisenberger, Ute, University Hospital Duisburg-Essen, Essen, Germany

Ute Eisenberger,

• Ertasoglu, Onurcan, University Hospital Duisburg-Essen, Essen, Germany

Onurcan Ertasoglu,

• Rohn, Hana, University Hospital Duisburg-Essen, Essen, Germany

Hana Rohn,

• Justa, Friebus-Kardash, University Hospital Duisburg-Essen, Essen, Germany

Friebus-Kardash Justa,

• Kribben, Andreas, University Hospital Duisburg-Essen, Essen, Germany

Andreas Kribben,

• Witzke, Oliver, University Hospital Duisburg-Essen, Essen, Germany

Oliver Witzke,

• Dahdal, Suzan, Inselspital, University of Bern, Bern, BE, Switzerland

Suzan Dahdal,

• Arampatzis, Spyridon, Inselspital, University of Bern, Bern, BE, Switzerland

Spyridon Arampatzis,

• Gaeckler, Anja H., University Hospital Duisburg-Essen, Essen, Germany

Anja H. Gaeckler,

Background

Conventional clinical markers often fail to predict recovery from ischemia-reperfusion injury in the early phase after kidney transplantation (KTx). Urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor 7 (IGFBP7), markers for G1 cell cycle arrest, have been identified and validated for the early detection of renal injury in critical ill patients. We evaluated whether post-transplant urinary [TIMP-2]*[IGFBP7] can predict renal recovery early after KTx.

Methods

In a prospective observational multicenter cohort study of renal transplant recipients, urinary [TIMP-2]*[IGFBP7] (NephroCheck^®; Astute Medical, San Diego, CA, USA) was evaluated daily from day 1-7 after KTx. Different stages of graft function were defined: immediate graft function (IGF) (decrease ≥ 10% s-crea within 24 h post KTx); slow graft function (SGF) (decrease <10% s-crea within 24 h post KTx) and delayed-graft function (DGF)(any dialysis during first week after KTx). Clinical and laboratory parameter were documented.

Results

A total of 186 KTx patients were analyzed, 138 (74%) with a deceased donor, 48 (26%) with a living donor KTx. IGF was observed in 58.6%, SGF in 23.1% and DGF in 18.3% of the cohort. [TIMP-2]*[IGFBP7] was significantly elevated in patients with DGF compared to other groups during the first week of transplant (Fig. 1). Renal function parameters were not able to differentiate between DGF and SGF early after Ktx. ROC-Analysis of [TIMP-2]*[IGFBP7] at day1 posttransplant for event “Non-DGF” revealed a cut-off value of 0,9 (ng/ml)²/1000 (sensitivity 87%; specificity 71%). Positive predictive value for non-DGF was 93%.

Conclusion

Early [TIMP-2]*[IGFBP7] measurement can predict recovery from ischemia-reperfusion-injury post Ktx. [TIMP-2]*[IGFBP7] is a promising biomarker for clinical decision-making after KTx.

Funding

• Commercial Support – Astute (only limited support on test material, no financial support)