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Open AccessArticle

Urinary Biomarkers α-GST and π-GST for Evaluation and Monitoring in Living and Deceased Donor Kidney Grafts

1
Department of General, Visceral and Transplantation Surgery, Universitätsklinikum Münster, 48189 Münter, Germany
2
Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Surgery CCM|CVK, 10117 Berlin, Germany
3
Department of Nephrology and Internal Intensive Care Medicine, Charité Universitätsmedizin Berlin, Campus Virchow Klinikum, 10117 Berlin, Germany
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(11), 1899; https://doi.org/10.3390/jcm8111899
Received: 22 October 2019 / Revised: 4 November 2019 / Accepted: 5 November 2019 / Published: 7 November 2019
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Kidney Transplantation)
The aim of this study was to analyze the value of urine α- and π-GST in monitoring and predicting kidney graft function following transplantation. In addition, urine samples from corresponding organ donors was analyzed and compared with graft function after organ donation from brain-dead and living donors. Urine samples from brain-dead (n = 30) and living related (n = 50) donors and their corresponding recipients were analyzed before and after kidney transplantation. Urine α- and π-GST values were measured. Kidney recipients were grouped into patients with acute graft rejection (AGR), calcineurin inhibitor toxicity (CNI), and delayed graft function (DGF), and compared to those with unimpaired graft function. Urinary π-GST revealed significant differences in deceased kidney donor recipients with episodes of AGR or DGF at day one after transplantation (p = 0.0023 and p = 0.036, respectively). High π-GST values at postoperative day 1 (cutoff: >21.4 ng/mg urine creatinine (uCrea) or >18.3 ng/mg uCrea for AGR or DGF, respectively) distinguished between rejection and no rejection (sensitivity, 100%; specificity, 66.6%) as well as between DGF and normal-functioning grafts (sensitivity, 100%; specificity, 62.6%). In living donor recipients, urine levels of α- and π-GST were about 10 times lower than in deceased donor recipients. In deceased donors with impaired graft function in corresponding recipients, urinary α- and π-GST were elevated. α-GST values >33.97 ng/mg uCrea were indicative of AGR with a sensitivity and specificity of 77.7% and 100%, respectively. In deceased donor kidney transplantation, evaluation of urinary α- and π-GST seems to predict different events that deteriorate graft function. To elucidate the potential advantages of such biomarkers, further analysis is warranted. View Full-Text
Keywords: kidney transplantation; urinary biomarkers; α-GST; π-GST; acute rejection; delayed graft function; nephrotoxicity kidney transplantation; urinary biomarkers; α-GST; π-GST; acute rejection; delayed graft function; nephrotoxicity
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Katou, S.; Globke, B.; Morgul, M.H.; Vogel, T.; Struecker, B.; Otto, N.M.; Reutzel-Selke, A.; Marksteiner, M.; Brockmann, J.G.; Pascher, A.; Schmitz, V. Urinary Biomarkers α-GST and π-GST for Evaluation and Monitoring in Living and Deceased Donor Kidney Grafts. J. Clin. Med. 2019, 8, 1899.

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