FP773
Increased post-operative recipient's delta neutrophil index is associated with early graft rejection in cadaver donor kidney transplantation Free

INTRODUCTION: Delta neutrophil index (DNI), representing an elevated fraction of circulating immature granulocyte in acute infection, has been reported as a useful predictable marker for mortality in patients with sepsis. We have hypothesized that increased recipient's post-operative (within 2 hours) DNI is associated with early rejection (within 1month) in cadaver donor kidney transplantation

METHODS: We investigated patients undergo kidney transplantation by cadaver donor from March 2013 to 2018 January retrospectively. The rejection was diagnosed by kidney biopsy with Banff classification and we excluded subclinical rejection

RESULTS: In a total of 73 cadaver kidney transplantation cases, 25 (34.2%) patients were diagnosed with rejection with Banff classification, among them 11 patients were diagnosed with rejection within early rejection. The recipient’s post-operative DNI was different between the patient with early rejection and the patient without rejection (0.18 vs 121, p<0.001). In univariate logistic regression analysis, Cold ischemic time, donor pre-operative creatinine level post-operative DNI level and peri-operative infection were associated with early rejection. However, in multivariate-adjusted logistic regression test, only high level of DNI (OR 12.307, 95% CI 1.212-124.928.5) was associated with rejection. The c-statistic was 0.777 (95% CI 0.604-0.951, p=0.004) for DNI respectively.

Table. Multivariate-adjusted logistic regression analysis for early rejection.

Figure. Kaplan-Meier curve for cumulative early rejection during follow-up.

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CONCLUSIONS: Increased post-operative Delta neutrophil index in cadaver donor kidney transplantation recipient might be one of the predictive value of early kidney rejection.