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, H. Thiessen-Philbrook, M. Bimali, C. R. Parikh

Research output: Contribution to journalArticlepeer-review

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
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Nephrology

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