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Complete Blood Count in Delayed Graft Function: A Narrative Review.

Marlene Marisol Perales-Quintana1, Edelmiro Perez Rodriguez2, Allina P Flores-Mendoza2

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Complete blood count (CBC) parameters can help predict delayed graft function (DGF) after kidney transplants. Low hemoglobin and elevated neutrophil-to-lymphocyte ratio (NLR) are linked to higher DGF risk, suggesting accessible monitoring.

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Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Hematology

Background:

  • Delayed graft function (DGF) is a frequent complication post-kidney transplant, causing acute kidney injury and requiring dialysis.
  • Early identification of patients at risk for DGF is vital for improving perioperative care and transplant outcomes.
  • Current novel biomarkers for DGF lack widespread clinical application.

Purpose of the Study:

  • To review the potential of complete blood count (CBC) parameters and derived indices as accessible and cost-effective predictors of DGF risk in kidney transplantation.
  • To synthesize existing research on the association between CBC parameters and DGF.

Main Methods:

  • A narrative review of studies investigating CBC parameters (hemoglobin, WBC, platelet count) and hematological indices (NLR, PLR) in relation to DGF risk.
  • Literature search conducted across major biomedical databases using targeted keywords.
  • Analysis of selected studies for predictive value, underlying mechanisms, and clinical utility.

Main Results:

  • Significant associations found between specific CBC parameters and DGF risk.
  • Low pre/perioperative hemoglobin and elevated pre/post-transplant NLR correlate with increased DGF risk.
  • Low pre-transplant hemoglobin and perioperative declines >1.3 g/dL, along with preoperative NLR >3.5, show promise for early detection.

Conclusions:

  • CBC-derived parameters, particularly hemoglobin levels and NLR, show potential for predicting DGF risk in kidney transplant recipients.
  • These parameters may reflect underlying inflammatory responses and ischemia-reperfusion injury.
  • Further prospective multicenter studies are needed to validate findings and establish standardized cutoff values for clinical use.