PloS one · 2026
Deceased kidney donor cystatin C and subsequent recipient measured glomerular filtration rate at one year after transplantation.
СтатьяНазвание и аннотация: Перевод в очереди
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Dielwart Isabelle J C, Kremer Daan, Knobbe Tim J, Groothof Dion, Leuvenink Henri G D, Kootstra-Ros Jenny E, de Borst Martin H, van Londen Marco, Sanders Jan-Stephan F, Pol Robert A, Bakker Stephan J L, TransplantLines investigators
Аннотация
BACKGROUND: Deceased donor kidney selection is largely determined by creatinine-based kidney function estimation. However, muscle wasting is common in potential donors and affects the accuracy of creatinine-based kidney function assessment. Cystatin C could serve as a muscle-mass independent alternative for this purpose. The primary aim of this study was to evaluate the associations of donor creatinine and cystatin C with recipient measured glomerular filtration (mGFR) at one year after transplantation.
METHODS: Using data from the prospective TransplantLines study, multivariable linear regression analyses were performed to examine the associations of donor plasma creatinine and cystatin C with recipient I125-iothalamate mGFR.
RESULTS: Donor plasma creatinine and cystatin C data were available for 96 donor-recipient pairs. Median pre-donation creatinine and cystatin C concentrations were 56.0 [49.5-71.0] µmol/L and 0.63 [0.50-0.82] mg/L, respectively. Recipient mGFR data at one year after transplantation were available in 55 kidney transplant recipients. Mean recipient mGFR was 52.1 ± 17.0 ml/min. Donor plasma creatinine was not associated with recipient mGFR (st. β -0.19, 95% CI [-0.48 to 0.10], p = 0.21), while donor cystatin C was significantly associated with recipient graft function (st. β -0.52, [-0.83 to -0.21], p = 0.002). The association of cystatin C and recipient mGFR remained materially unchanged after adjustment for potential confounders.
CONCLUSION: In deceased kidney donors, donor plasma creatinine is not associated with recipient mGFR, whereas donor cystatin is associated. Addition of cystatin C to the assessment of deceased kidney donors may provide additional information in difficult cases and improve the accuracy of deceased kidney donor selection.
METHODS: Using data from the prospective TransplantLines study, multivariable linear regression analyses were performed to examine the associations of donor plasma creatinine and cystatin C with recipient I125-iothalamate mGFR.
RESULTS: Donor plasma creatinine and cystatin C data were available for 96 donor-recipient pairs. Median pre-donation creatinine and cystatin C concentrations were 56.0 [49.5-71.0] µmol/L and 0.63 [0.50-0.82] mg/L, respectively. Recipient mGFR data at one year after transplantation were available in 55 kidney transplant recipients. Mean recipient mGFR was 52.1 ± 17.0 ml/min. Donor plasma creatinine was not associated with recipient mGFR (st. β -0.19, 95% CI [-0.48 to 0.10], p = 0.21), while donor cystatin C was significantly associated with recipient graft function (st. β -0.52, [-0.83 to -0.21], p = 0.002). The association of cystatin C and recipient mGFR remained materially unchanged after adjustment for potential confounders.
CONCLUSION: In deceased kidney donors, donor plasma creatinine is not associated with recipient mGFR, whereas donor cystatin is associated. Addition of cystatin C to the assessment of deceased kidney donors may provide additional information in difficult cases and improve the accuracy of deceased kidney donor selection.