Associations Between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes

S. G. Mansour, J. Puthumana, P. P. Reese, I. E. Hall, M. D. Doshi, F. L. Weng, B. Schröppel, Heather Thiessen Philbrook, M. Bimali, Chirag Parikh

Research output: Contribution to journalArticle

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 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.

Original languageEnglish (US)
Pages (from-to)749-758
Number of pages10
JournalKidney International Reports
Volume2
Issue number4
DOIs
StatePublished - Jul 1 2017

Keywords

  • 6-month eGFR
  • AKI
  • deceased donors
  • DGF
  • graft failure
  • MCP-1

ASJC Scopus subject areas

  • Nephrology

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    Mansour, S. G., Puthumana, J., Reese, P. P., Hall, I. E., Doshi, M. D., Weng, F. L., Schröppel, B., Thiessen Philbrook, H., Bimali, M., & Parikh, C. (2017). Associations Between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes. Kidney International Reports, 2(4), 749-758. https://doi.org/10.1016/j.ekir.2017.03.007