Urine liver-type fatty acid-binding protein predicts graft outcome up to 2 years after kidney transplantation

J. Yang, H. M. Choi, M. Y. Seo, J. Y. Lee, K. Kim, H. Jun, C. W. Jung, K. T. Park, M. G. Kim, S. K. Jo, W. Cho, H. K. Kim

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20 Citations (Scopus)


Background Several new biomarkers for the detection of early tubular injury have been investigated in kidney transplant recipients. We recently identified day 2 urinary neutrophil gelatinase-associated lipocalin (NGAL) as a predictor of slow graft function and adverse 1-year outcome. In the present study, we further investigated the value of urinary NGAL and liver-type fatty acid binding protein (L-FABP) for predicting long-term graft outcomes up to 2 years. Methods This study was a single-center, prospective observational study. Serial urinary NGAL and L-FABP levels at 0 hours, 2 days, and 6 days after kidney transplantation (KT) were measured, and the clinical data were assessed during the 2-year period after KT. Results During the 2-year follow-up period, 13 (18.8%), 5 (7.2%), and 4 (5.8%) patients were diagnosed with acute T-cell-mediated rejection, acute antibody-mediated rejection (AMR) and chronic AMR, respectively. In addition, 10 patients (14.3%) developed calcineurin inhibitor toxicity and 6 (8.7%) developed BK viremia. The mean estimated glomerular filtration rates (eGFR) at 1 and 2 years after KT were 65.1 ± 19.1 and 58.5 ± 22.6 mL/min/1.73 m2, respectively, When poor long-term graft function was defined as eGFR of less than 50 mL/min/1.73 m 2 at 2 years, elderly donors, acute rejection, and high 0-hour urinary L-FABP levels were significant risk factors. Furthermore, in rejection-free patients, L-FABP was strongly associated with poor long-term graft function (P =.006). Multivariate logistic regression analysis showed that high 0-hour L-FABP (P =.015) and acute rejection (P =.006) were independent factors predicting poor long-term graft function. Receiver operating characteristic analysis showed that the area under the curve for urinary L-FABP was 0.692 (P =.036). Conclusions Our results suggest that urinary L-FABP may be a useful predictor of adverse long-term outcomes in KT patients.

Original languageEnglish
Pages (from-to)376-380
Number of pages5
JournalTransplantation Proceedings
Issue number2
Publication statusPublished - 2014 Mar
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Transplantation


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