TY  - JOUR
A1  - Kaden, Jürgen
A1  - Abendroth, Dietmar
A1  - Völp, Andreas
A1  - Marzinzig, Michael
T1  - Dynamics and diagnostic relevance of kynurenine serum level after kidney transplantation
T2  - Annals of transplantation
N2  - BACKGROUND: Inflammatory events after kidney transplantation (Tx) may lead to activation of the tryptophane-catabolizing enzyme indoleamine 2,3-dioxygenase followed by the formation of kynurenine (KYN). Post-transplant KYN serum levels in kidney allograft recipients were analyzed for their diagnostic value.
MATERIAL AND METHODS: This was a retrospective analysis of KYN levels (normal value: 2.7±0.6 nmol/ml) measured in 4083 blood samples collected from 355 kidney graft recipients in connection with uncomplicated courses, acute rejections (ARs), infections, and type of immunosuppression. We performed descriptive data analysis and analysis of variance.
RESULTS: In 212 recipients with immediately functioning grafts, the KYN levels dropped from pre-Tx 13.3±5.9 nmol/ml to nearly normal values at day 5 (5.8±3.0 nmol/ml). In patients with delayed graft function, the KYN reduction started only after the last hemodialysis treatment. With respect to ARs in recipients with creatinine values <300 µmol/l pre-AR, the increase of KYN levels depended on the severity of ARs (steroid-sensitive ARs: from 4.5±1.4 to 6.0±6.1 nmol/ml; steroid-resistant ARs: from 6.1±3.1 to 12.9±7.1 nmol/ml; vascular rejections: from 5.8±3.0 to 16.9±9.1 nmol/ml). In patients with creatinine values ≥300 µmol/l pre-AR, a further increase of the KYN level (from 10.1 to 13.2 nmol/ml) was only observed in severe, steroid-resistant ARs. With respect to infections evaluated, the KYN levels before diagnosis/start of treatment were 5.7±3.4 nmol/ml in asymptomatic CMV infections, 7.5±4.4 nmol/ml in CMV diseases, 8.3±3.3 nmol/ml in pneumonia, and 10.4±6.5 nmol/ml in bacterial sepsis.
CONCLUSIONS: Serum KYN seems to be a reliable diagnostic tool for the assessment of post-transplant inflammatory complications, already in an early stage, and for monitoring the efficacy of therapeutic interventions. Prospective studies are recommended.
Y1  - 2016
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/38519
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-385199
SN  - 1425-9524
N1  - This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
VL  - 20
IS  - 337
SP  - 11
EP  - 327
PB  - Pressmed
CY  - Warsaw
ER  -