Urinary Tamm-Horsfall protein as a marker of renal transplant function

In a total of 428 urine samples collected from 15 patients aged between 23 and 60 years after cadaveric kidney transplantation during a postoperative hospital stay, Tamm-Horsfall protein (THP) was quantitatively determined using the ELIAS SYNELISA-THP immunoassay. All patients were treated with azathioprine, cyclosporine, prednisolone, given an intraoperative high-dose single antilymphocyte globulin bolus and discharged with functioning grafts. In clinically uncomplicated courses, even after immediate transplant function, the recovery of graft function took on average 7 days. Thereafter the urinary THP excretion was relatively stable and amounted, on average, to 14.5 +/- 4.9 mg/24 h (i.e. was at the lower limit of normal urinary THP excretion). In cases of delayed onset of graft function of undetermined origin accompanied by extremely reduced urinary THP excretion, the functional recovery, whether spontaneous or brought about by treatment, was characterized by a continuous increase in urinary THP excretion. In connection with interstitial rejections urinary THP excretion seems not to be a recommendable diagnostic parameter. Daily measurement of urinary THP is, however, suitable for monitoring the functional state of transplanted kidneys.