Pretransplant endotrophin predicts delayed graft function after kidney transplantation

International audience ; Delayed graft function after kidney transplantation is common and increases morbidity and health care costs. There is evidence that endotrophin, a specific fragment of pro-collagen type VI, promotes the inflammatory response in kidney diseases. We tested the hypothesis that pretransplant endotrophin in kidney transplant recipients may be associated with the risk of delayed graft function. Pretransplant plasma endotrophin was assessed using an enzyme-linked immunosorbent assay in three independent cohorts with 806 kidney transplant recipients. The primary outcome was delayed graft function, i.e., the necessity of at least one dialysis session within one-week posttransplant. In the discovery cohort median pretransplant plasma endotrophin was higher in 32 recipients ( 12%) who showed delayed graft function when compared to 225 recipients without delayed graft function (58.4 ng/mL [IQR 33.4-69.0]; N = 32; vs. 39.5 ng/mL [IQR 30.6-54.5]; N = 225; P = 0.009). Multivariable logistic regression, fully adjusted for confounders showed, that pretransplant plasma endotrophin as a continuous variable was independently associated with delayed graft function in both validation cohorts, odds ratio 2.09 [95% CI 1.30-3.36] and 2.06 [95% CI 1.43-2.97]. Pretransplant plasma endotrophin, a potentially modifiable factor, was independently associated with increased risk of delayed graft function and may be a new avenue for therapeutic interventions. Abbreviations DGF Delayed graft function DBD Donation after brain death DCD Donation after circulatory death Endotrophin Pro-collagen type VI fragment OR Odds ratio 95% CI 95 Percent confidence interval Delayed graft function (DGF) after kidney transplantation describes the failure of the allograft to operate properly due to ischemia-reperfusion injury and a subsequent inflammatory response 1 . This complication can be observed in up to 40 percent of deceased donor kidney transplant recipients, prolongs patient hospitalization, increases morbidity and health care ...