Urinary hepatocyte growth factor indicates ischemia/reperfusion injury after kidney transplantation.

Abstract

Despite the development of immunosuppressive regimens in kidney transplantation, long-term graft survival rates have not increased significantly. One of the causes of long-term graft loss is ischemia-reperfusion insult. Hepatocyte growth factor (HGF) is a regenerative factor produced in response to injury. Our aim was to assess the effect of HGF and xanthine oxidase (indicators of ischemia/reperfusion insult) on early and late kidney function. In 17 patients, HGF levels in urine and xanthine oxidase activity in blood were examined 1, 7, 14, 30 days, 3 and 6 months after kidney transplantation. We also measured 24-hour diuresis and serum creatinine levels after transplantation. Urinary HGF levels were highest 1 day after transplantation. During the following week, it rapidly decreased and was maintained at similar levels in the later period. Creatinine at 1 day showed a positive correlation with urinary HGF levels at 1 day and at 3 months (R = 0.54, P <0.05 and R = 0.82, P <0.01, respectively). Creatinine at 7 days positively correlated with HGF levels at 6 months (R = 0.82, P <0.05). HGF levels at 1 day and at 6 months positively correlated with xanthine oxidase activity at 1 day (R = 0.73, P <0.001 and R = 0.77, P <0.02, respectively). A negative correlation was observed between HGF levels at 6 months and diuresis 1 and 7 days after transplantation (R = -0.99, P <0.00 001 and R = -0.77, P <0.05, respectively). Urinary HGF is a good marker of perioperative kidney damage and may affect long-term graft function.