Early Predictors of Acute Kidney Injury after Lung Transplantation: a prospective observational study

Background and aims Lung transplant (LUTX) is a feasible option for end-stage respiratory failure. Acute kidney injury (AKI) is a common and impactful complication of LUTX. Urinary cell cycle arrest proteins as early indicators of AKI have never been tested in LUTX recipients. Methods In a single-center prospective observational study, we assessed the capabilities of early urinary Tissue Inhibitor of Metalloproteinase-2 (TIMP-2) and Insulin-Like Growth Factor Binding Protein 7 (IGFBP7) in predicting AKI following KDIGO criteria, in adult patients undergone primary double LUTX. AKI score was measured at 6 and 36 hours from graft reperfusion. Results Thirty consecutive adult LUTX patients were included (18(60%) males, 51.5(43.8-60) years old, Lung Allocation Score 40.5(36.6-46.6), restrictive disease 14(46%)). Enlistment estimated glomerular filtration rate was 91.0 (74.5-106.0) mL/min/1.73 m2. AKI score was >0.3 at 6 and 36 hours detected in 10 (33%) patients and 16 (53%) patients, respectively. 6-hours AKI score >0.3 was associated with increased risk of AKI >0 (p=0.036, OR 6.0 (1.2-31)) with AUC 0.66 (0.49-0.8 95% CI). 36-hours AKI score >0.3 was associated with increased risk of AKI >0 (p=0.049, OR 5.9 (1.0-35)) with AUC 0.65 (0.47-0.81 95%CI) (Fig 1). Conclusions Measurement of urinary cell cycle arrest proteins was predictive of AKI and may be used to guide AKI preventive measures in LUTX recipients. <fig><object-id>erj;64/suppl_68/PA4985/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>