Neutrophil-lymphocyte ratio and creatinine reduction ratio predict good early graft function among adult cadaveric donor renal transplant recipients. Single institution series
Journal Title: Polish Journal of Surgery - Year 2018, Vol 90, Issue 2
Abstract
Background Delayed graft function (DGF) is a common complication following kidney transplantation and is associated with ischemia-reperfusion injury (IRI). Lymphocytes contribute to the pathogenesis of IRI and ischemia-reperfusion related delayed graft function Materials and Methods 135 Caucasian patients received a kidney graft from deceased heart-beating organ donors. We divided patients into 2 groups- patients with the eGFR>=30 on the 21st day post-transplantation (n=36) and patients with the eGFR<30 on the 21st day post-transplantation (n=99) to assess kidney graft function. We measured the serum creatinine levels on 1st and 2nd post-transplant day and preoperative levels of monocytes, lymphocytes, platelets and neutrophils and their ratios. Results We have found statistically significant differences between the eGFR<30 and the eGFR>=30 groups in the average lnLymphocytes (0,36 +/-0,6 vs -0,016 +/-0,74 respectively p=0,004) lnNLR ( 1,27 +/-0,92 vs. 1,73+/-1,08 p=0,016) lnLMR (1,01 +/-0,57 vs. 0,73 +/-0,64 p=0,02), lnPLR (4,97 +/-0,55 vs. 5,26 +/- 0,67 p=0,023) and CCR2% (-20,20 +/- 21,55 vs. -4,29 +/- 29,62 p=0,004 . On univariate analysis, factors of lnLymphocytes >=0,22 (OR=0,331 95%CI 0,151-0,728 p=0,006), lnLMR>=1,4 (OR=0,255 95%CI 0,072-0,903 p=0,034) were associated with worse graft function while lnNLR>=1,05 (OR=2,653 95%CI 1,158-6,078 p=0,021), lnPLR>=5,15 (OR=2,536 95%CI 1,155-5,566 p=0,02) and CRR2 (OR=3,286 95% CI 1,359-7,944 p=0,008) indicated better graft function Conclusion Higher absolute lymphocyte count (lnLymphocytes) and lnLMR as well as lower lnNLR and lnPLR were associated with lower eGFR on the 21st day after kidney transplantation. On multivariate analysis CRR2 in combination with either lnLymphocytes, lnNLR or lnPLR improved the accuracy of detecting patients with poor graft function.<br/><br/>
Authors and Affiliations
Piotr Hogendorf, Anna Suska, Aleksander Skulimowski, Joanna Rut, Monika Grochowska, Aleksandra Wencel, Filip Dziwisz, Michał Nowicki, Dariusz Szymański, Grażyna Poznańska, Adam Durczyński, Janusz Strzelczyk
Effects of bariatric surgery on cardiovascular risk factors among morbidly obese patients
Aim of the study: The aim of this study was to evaluate the influence of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric by-pass on risk factors of cardiovascular diseases. Material and methods: We ana...
Evaluation Of Irritable Bowel Syndrome Symptoms Amongst Warsaw University Students
Irritable bowel syndrome (IBS) belongs to functional gastrointestinal disorders and is characterized by abdominal pain and change in stool consistency and/or bowel habits. Etiological factors include gastrointestinal per...
Risk factors in reoperations in colorectal surgery
Background: Reoperations in colorectal surgery are usually a consequence of major surgical complications. Recently, the rate of reoperation has been proposed as a marker of surgical performance. Yet, the incidence of re-...
Intraperitoneal alloplasty combined with the anterior component separation in giant incisional hernias
The use of the anterior technique for abdominal wall components separation combined with “onlay” alloplasty (ACST + onlay) in giant incisional hernias (IH) may pose a surgical challenge as it does not exclude increased i...
Safety and efficacy of a Ventralight ST echo ps implant for a laparoscopic ventral hernia repair – a prospective cohort study with a one-year follow-up
Laparoscopic ventral hernia repair has become popular technique. Every year, companies are introducing new products Thus, every mesh prior to introduction in clinical settings should be tested with a dedicated tacker to...