Biomarker Prediction of Delayed Graft Function and Prognosis Post-Kidney Transplantation

Area of Science:

• Nephrology
• Transplant Immunology
• Biomarker Discovery

Background:

• Delayed graft function (DGF) and long-term prognosis are critical concerns in kidney transplantation.
• Identifying reliable biomarkers for DGF prediction and patient outcomes is essential for improving transplant success rates.

Purpose of the Study:

• To evaluate Aminoacylase-1 (ACY1) and other serum biomarkers for predicting delayed graft function (DGF) and death-censored graft survival (DCGS) after kidney transplantation.
• To assess the performance of these biomarkers in both discovery and validation cohorts.

Main Methods:

• Serum samples were collected from kidney transplant recipients in two phases: a discovery cohort (n=237) and a validation cohort (n=319).
• Biomarkers including ACY1, soluble tumor necrosis factor receptor-1 (sTNFR1), and cystatin C (CysC) were measured at specific time points post-transplant.
• Statistical analyses, including receiver operating characteristic (ROC) analysis, were used to assess predictive performance for DGF and DCGS.

Main Results:

• A combined biomarker panel (ACY1, sTNFR1, CysC) showed a high area under the ROC curve (AUROC) of 0.93 for DGF prediction in the discovery phase, decreasing to 0.83 in validation.
• Individual biomarkers sTNFR1, CysC, and serum creatinine (Cr) were significantly associated with DCGS in both phases.
• ACY1 and CysC showed a consistent association with DCGS in deceased donor kidney transplants (DDKTs) experiencing DGF.

Conclusions:

• Several biomarkers, including ACY1, sTNFR1, and CysC, demonstrate potential for predicting DGF and transplant outcomes.
• Further investigation and validation are warranted to integrate these biomarkers into clinical practice for improved kidney transplant management.