Naples Prognostic Score May Be Associated With Acute Rejection in Kidney Transplant Patients: A Single Center Experience

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-08-28 DOI:10.1111/ctr.70294

Ramazan Danis, Eren Eynel, Jehat Kilic, Nurettin Ay

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引用次数: 0

Abstract

Background

The Naples Prognostic Score (NPS) is a comprehensive measure of patients' inflammatory and nutritional status. In this study, we compared the preoperative NPS of kidney transplant recipients who experienced acute rejection (AR) with those who did not.

Materials and Methods

This retrospective study included 294 patients who underwent kidney transplantation and were followed up at our hospital between January 2012 and January 2024. NPS was calculated based on laboratory values obtained 1 day before the transplantation surgery. Patients were divided into two groups according to the occurrence of biopsy-proven acute rejection (AR): Group A consisted of patients who developed AR, and Group B comprised those without AR.

Results

Our analysis revealed a significant difference between Group A and Group B regarding donor type (living or cadaveric) (p = 0.016). Furthermore, a significant difference was observed in the comparison of the Naples Prognostic Score (p = 0.014). The subsequent multivariate analysis showed that cadaveric donor status significantly increased the risk of acute rejection (HR = 2.935 [95% CI, 1.250–6.893], p = 0.013). Additionally, patients with a Naples score of 3–4 had a higher risk of acute rejection compared to those with a score of 0–2 (HR = 2.142 [95% CI, 1.160–3.955], p = 0.015).

Conclusions

Preoperative Naples Prognostic Score, may influence the risk of acute rejection in the postoperative period. A higher NPS is associated with an increased risk of acute rejection, which may subsequently lead to graft dysfunction.

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那不勒斯预后评分可能与肾移植患者的急性排斥反应有关：单中心经验

那不勒斯预后评分（Naples Prognostic Score， NPS）是衡量患者炎症和营养状况的综合指标。在这项研究中，我们比较了发生急性排斥反应（AR）的肾移植受者和没有发生急性排斥反应的肾移植受者的术前NPS。材料与方法回顾性研究2012年1月至2024年1月在我院行肾移植手术的294例患者。NPS根据移植手术前1天的实验室值计算。根据活检证实的急性排斥反应（AR）的发生情况将患者分为两组：A组为发生AR的患者，B组为未发生AR的患者。结果我们的分析显示，A组和B组在供体类型（活体或尸体）方面存在显著差异（p = 0.016）。那不勒斯预后评分（Naples Prognostic Score）比较差异有统计学意义（p = 0.014）。随后的多因素分析显示，尸体供体身份显著增加急性排斥反应的风险（HR = 2.935 [95% CI, 1.250-6.893], p = 0.013）。此外，那不勒斯评分为3-4分的患者发生急性排斥反应的风险高于评分为0-2分的患者（HR = 2.142 [95% CI, 1.160-3.955], p = 0.015）。结论术前那不勒斯预后评分可影响术后急性排斥反应的发生。较高的NPS与急性排斥反应的风险增加有关，这可能随后导致移植物功能障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.