Neutrophil-lymphocyte ratio and creatinine reduction ratio predict good early graft function among adult cadaveric donor renal transplant recipients. Single institution series

The Background Delayed graft function (DGF) is a common complication following kidney transplantation and is associated with ischemia-reperfusion injury (IRI). Lymphocytes contribute to the pathogenesis of IRI and ischemia-reperfusion related to delayed graft function. Materials and Methods : 135 Caucasian patients received a kidney graft from deceased heart-beating organ donors. We divided patients into 2 groups - patients with the eGFR>=30 on the 21st day post-transplantation (n=36) and patients with the eGFR<30 on the 21st day post-transplantation (n=99) to assess kidney graft function. We measured serum creatinine levels on 1st and 2nd post-transplant day and preoperative levels of monocytes, lymphocytes, platelets, and neutrophils and their ratios. Results: We have found statistically significant differences between the eGFR<30 and the eGFR>=30 groups in the average lnLymphocytes (0.36 +/-0.6 vs. -0.016 +/-0.74, respectively p=0.004) lnNLR (1,27 +/-0.92 vs. 1.73+/-1.08 p=0.016) lnLMR (1.01 +/-0.57 vs. 0.73 +/-0.64 p=0.02), lnPLR (4.97 +/-0.55 vs. 5.26 +/- 0.67 p=0.023), and CCR 2% (-20.20 +/- 21.55 vs. -4.29 +/- 29.62 p=0.004. In the univariate analysis, factors of lnLymphocytes >=0.22 (OR=0.331 95%CI 0.151-0.728 p=0.006), lnLMR>=1.4 (OR=0.255 95%CI 0.072-0.903 p=0.034) were associated with a worse graft function, while lnNLR>=1.05 (OR=2.653 95%CI 1.158-6,078 p=0.021), lnPLR>=5.15 (OR=2.536 95%CI 1.155-5.566 p=0.02) and CRR2 (OR=3.286 95% CI 1.359-7.944 p=0.008) indicated a better graft function. Conclusion: A higher absolute lymphocyte count (lnLymphocytes) and lnLMR, as well as lower lnNLR and lnPLR were associated with a lower eGFR on the 21st day after kidney transplantation. In the multivariate analysis, CRR2 in combination with either lnLymphocytes, lnNLR or lnPLR improved the accuracy of detecting patients with poor graft function.