Serum β2-Microglobulin Predicts Time to Recovery of Delayed Graft Function in Kidney Transplant Recipients

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2024-08-19 DOI:10.1111/ctr.15435

Sandesh Parajuli, Margaret Bloom, Didier Mandelbrot, Brad C. Astor

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Abstract

Background

Delayed graft function (DGF) after kidney transplantation is associated with adverse patients and allograft outcomes. A longer duration of DGF is predictive of worse graft outcomes compared to a shorter duration. Posttransplant serum β2-microglobulin (B2M) is associated with long-term graft outcomes, but its relationship with DGF recovery is unknown.

Methods

We included all kidney-only transplant recipients with DGF enrolled in the E-DGF trial. Duration of DGF was defined as the interval between the transplant and the last dialysis session. We analyzed the association of standardized serum creatinine (Scr) and B2M on postoperative Days (POD) 1–7 during the subsequent days of DGF with the recovery of DGF.

Results

A total of 97 recipients with DGF were included. The mean duration of DGF was 11.0 ± 11.2 days. Higher Scr was not associated with the duration of DGF in unadjusted or adjusted models. Higher standardized B2M, in contrast, was associated with a prolonged duration of DGF. This association remained in models adjusting for baseline characteristics from POD 2 (3.19 days longer, 95% CI: 0.46–5.93; p = 0.02) through Day 6 of DGF (4.97 days longer, 95% CI: 0.75–9.20; p = 0.02). There was minimal change in mean Scr (0.01 ± 0. 10 mg/dL per day; p = 0.32), while B2M significantly decreased as the time to recovery approached (–0.14 ± 0.05 mg/L per day; p = 0.006), among recipients with DGF.

Conclusion

B2M is more strongly associated with DGF recovery than Scr. Posttransplant B2M may be an important biomarker to monitor during DGF.

Trial Registration: ClinicalTrials.gov identifier: NCT 03864926

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血清β2-微球蛋白预测肾移植受者移植功能延迟恢复的时间

背景：肾移植后移植物功能延迟（DGF）与患者和异体移植物的不良预后有关。与持续时间较短相比，持续时间较长的 DGF 可预测较差的移植物预后。移植后血清β2-微球蛋白（B2M）与长期移植物预后有关，但其与DGF恢复的关系尚不清楚：我们纳入了所有参加 E-DGF 试验的 DGF 单纯肾移植受者。DGF持续时间定义为移植与最后一次透析之间的时间间隔。我们分析了DGF随后几天内术后第1-7天（POD）的标准血清肌酐（Scr）和B2M与DGF恢复的关系：结果：共纳入97名DGF受者。DGF 的平均持续时间为 11.0 ± 11.2 天。在未经调整或调整后的模型中，较高的 Scr 与 DGF 持续时间无关。相反，标准化 B2M 越高，DGF 持续时间越长。在调整基线特征的模型中，从 POD 2（延长 3.19 天，95% CI：0.46-5.93；p = 0.02）到 DGF 第 6 天（延长 4.97 天，95% CI：0.75-9.20；p = 0.02），这种关联仍然存在。DGF受者的平均Scr变化很小（每天0.01 ± 0. 10 mg/dL；p = 0.32），而随着恢复时间的临近，B2M显著下降（每天-0.14 ± 0.05 mg/L；p = 0.006）：结论：B2M与DGF恢复的关系比Scr更密切。移植后 B2M 可能是监测 DGF 的重要生物标志物：试验注册：ClinicalTrials.gov identifier：NCT03864926。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.