Increased resistin in brain dead organ donors is associated with delayed graft function after kidney transplantation

Abstract

Introduction: Resistin increases during several inflammatory diseases and after intracerebral bleeding or head trauma. Resistin activates the endothelium and may initiate an inflammatory response. No data are available on resistin in brain dead donors (DBD) that regularly manifest a pronounced inflammatory state.

Methods: We analyzed plasma resistin in 63 DBDs and correlated results with donor variables and the postoperative course following kidney transplantation using organs from these donors. Endocan and monocyte chemotactic protein (MCP)-1 were also studied. Twenty-six live kidney donors (LD) and the corresponding kidney transplantations were used as controls.

Results: DBDs had higher resistin (median/range 30.75 ng/ml, 5.41-173.6) than LD (7.71 ng/ml, 2.41-15.74, p < 0.0001). Resistin in DBD correlated with delayed graft function (DGF) in the kidney recipients (r = 0.321, p < 0.01); receiver operating characteristic curve revealed an area under the curve of 0.765 (95% confidence interval [CI] 0.648-0.881, p < 0.01) and a cut-off value for resistin of 25 ng/ml; MCP-1 and endocan were higher in DBDs (p < 0.0001) but did not correlate with DGF or acute rejection. No relationship was found between the studied molecules and the postoperative course of LD kidney transplants.

Conclusions: High resistin levels in the DBD before organ retrieval are associated with DGF after kidney transplantation. The resistin increase seems related to the inflammatory state after brain death but not to the cause of death.

Figure 1

The enzyme-linked immunosorbent assay (ELISA) results in the plasma of brain dead organ donors (DBD, grey box) and living donors (LD, open box). DBDs had higher plasma concentrations of resistin (A), MCP-1 (B) and endocan (C) as compared with LD.

Figure 2

Receiver operating characteristic curve of resistin as predictor of DGF. Area under the curve followed by SE and 95% CI are shown.

Figure 3

The decrease in post-operative serum creatinine concentrations during the first week in recipients of kidneys from DBD donors with resistin <25 ng/ml (grey bars, n = 24), resistin >25 ng/ml (black bars, n = 39) and living donors (white bars, n = 26). * p < 0.05.