Comparison of macrophage migration inhibitory factor and neutrophil gelatinase-associated lipocalin-2 to predict acute kidney injury after liver transplantation: An observational pilot study

• Published in: PloS one Vol. 12; no. 8; p. e0183162
• Main Authors: Baron-Stefaniak, Joanna, Schiefer, Judith, Miller, Edmund J, Berlakovich, Gabriela A, Baron, David M, Faybik, Peter
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 15-08-2017; Public Library of Science (PLoS)
• Subjects: Acute kidney failure; Acute Kidney Injury - blood; Acute Kidney Injury - surgery; Acute Kidney Injury - urine; Bioindicators; Biology and Life Sciences; Biomarkers; Cell migration; Comparative analysis; Complications and side effects; Confidence intervals; Cytokines; Drug dosages; Female; Gelatinase; Hospitals; Humans; Injuries; Intensive care; Kidney diseases; Kidney transplantation; Kidneys; Leukocyte migration; Lipocalin; Lipocalin-2 - blood; Lipocalin-2 - urine; Liver; Liver diseases; Liver Transplantation; Liver transplants; Macrophage migration inhibitory factor; Macrophage Migration-Inhibitory Factors - blood; Macrophage Migration-Inhibitory Factors - urine; Macrophages; Male; Medical prognosis; Medicine; Medicine and Health Sciences; Middle Aged; Neutrophils; Pain; Patients; Predictive Value of Tests; Prospective Studies; Reperfusion; Risk factors; ROC Curve; Surgery; Transplantation; Transplants & implants; Urine
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0183162

Several biomarkers have been suggested as early predictors of acute kidney injury (AKI) after orthotopic liver transplantation (OLT). Neutrophil gelatinase-associated lipocalin-2 (NGAL) appears to be a promising predictor of AKI after OLT, but the clinical benefit remains to be proven. Recently, systemic macrophage migration inhibitory factor (MIF) has been proposed as early indicator for requirement of renal replacement therapy after OLT. The aim of this prospective, observational pilot study was to compare the predictive values of serum and urinary MIF for severe AKI after OLT to those of serum and urinary NGAL.
Concentrations of MIF and NGAL were measured in serum and urine samples collected from patients undergoing OLT. Acute kidney injury was classified according to the KDIGO criteria, with stages 2 and 3 summarized as severe AKI. Areas under the receiver operating curves (AUC) were calculated to assess predictive values of MIF and NGAL for the development of severe AKI.
Forty-five patients (mean age 55±8 years) were included. Nineteen patients (38%) developed severe AKI within 48 hours after reperfusion. At the end of OLT, serum MIF was predictive of severe AKI (AUC 0.73; 95% confidence intervals, CI 0.55-0.90; P = 0.03), whereas urinary MIF, serum NGAL, and urinary NGAL were not. On the first postoperative day, serum MIF (AUC 0.78; CI 0.62-0.93; P = 0.006), urinary MIF (AUC 0.71; CI 0.53-0.88; P = 0.03), and urinary NGAL (AUC 0.79; CI 0.64-0.93; P = 0.02) were predictive for severe AKI, while serum NGAL was not.
In the setting of OLT, MIF and NGAL had similar predictive values for the development of severe AKI.