Louise Benning, Marvin Reineke, Camila Eleuterio Rodrigues, Florian Kälble, Claudius Speer, Claudia Sommerer, Christoph F Mahler, Felix C F Schmitt, Markus Mieth, Martin Zeier, Christoph Michalski, Arianeb Mehrabi, Oliver Hartmann, Markus Zorn, Sophie C Anker, David Czock, Markus A Weigand, Zoltan Endre, Christian Morath, Christian Nusshag
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引用次数: 0
Abstract
Accurate assessment of graft function trajectories after kidney transplantation is essential for optimizing patient management. Slow graft function (SGF) and delayed graft function (DGF) are associated with impaired recovery, yet current diagnostic tools lack granularity for timely risk stratification. Proenkephalin A 119-159 (penKid) may improve graft function assessment, enhancing risk stratification for SGF, DGF, and associated outcomes. This prospective study evaluated 159 kidney transplant recipients at Heidelberg University Hospital to compare plasma penKid levels with current risk-indicators for poor (functional) graft trajectories. Validation was conducted using an independent transplant cohort from Sydney. Clinical relevance of biomarker-indicated changes in graft function was assessed using multivariable regression models and AUROC analyses. From day one post-transplant, penKid outperformed serum creatinine (SCr) in identifying functional trajectories associated with DGF (AUROC penKid: 0.87 vs. SCr: 0.56) and differentiated SGF from DGF (AUROC penKid: 0.79 vs. SCr: 0.33) up to eight days earlier. PenKid further demonstrated superior granularity in assessing DGF severity and 30-day outcomes. After adjustment for common risk factors, penKid remained the strongest risk stratifier for all tested outcomes. PenKid is a superior biomarker for earlier assessment of graft function trajectories, offering potential to enhance personalized care and clinical trial designs in kidney transplantation.
Proenkephalin A 119-159在肾移植中：一种新的生物标志物，用于更好地跟踪移植物功能轨迹。
准确评估肾移植后移植物功能轨迹对于优化患者管理至关重要。移植物功能缓慢（SGF）和移植物功能延迟（DGF）与恢复受损有关，但目前的诊断工具缺乏及时的风险分层粒度。Proenkephalin A 119-159 （penKid）可能改善移植物功能评估，增强SGF、DGF和相关结果的风险分层。这项前瞻性研究评估了海德堡大学医院的159名肾移植受者，比较血浆penKid水平与目前不良（功能）移植轨迹的风险指标。通过来自悉尼的独立移植队列进行验证。使用多变量回归模型和AUROC分析评估生物标志物指示的移植物功能变化的临床相关性。从移植后第一天起，penKid在识别与DGF相关的功能轨迹方面优于血清肌酐（SCr） （AUROC penKid: 0.87 vs. SCr: 0.56），并在8天前将SGF与DGF区分开来（AUROC penKid: 0.79 vs. SCr: 0.33）。PenKid进一步证明了在评估DGF严重程度和30天预后方面的卓越粒度。在对常见风险因素进行调整后，penKid仍然是所有测试结果中最强的风险分层因素。PenKid是早期评估移植物功能轨迹的优越生物标志物，具有增强肾移植个性化护理和临床试验设计的潜力。
期刊介绍：
The aim of the journal is to serve as a forum for the exchange of scientific information in the form of original and high quality papers in the field of transplantation. Clinical and experimental studies, as well as editorials, letters to the editors, and, occasionally, reviews on the biology, physiology, and immunology of transplantation of tissues and organs, are published. Publishing time for the latter is approximately six months, provided major revisions are not needed. The journal is published in yearly volumes, each volume containing twelve issues. Papers submitted to the journal are subject to peer review.
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