Uso de novos biomarcadores no diagnóstico precoce de lesão renal aguda pós- transplante hepático

Abstract

Acute kidney injury (AKI) is a common complication after liver transplantation. Clinical markers for diagnosis are very limited, which contributed to the search for more specific biomarkers for their early diagnosis. NGAL, renal tubular biomarker and syndecan-1, endothelial biomarker were used in the study. Objectives: To assess the correlation between early detection of NGAL and Syndecan-1 and AKI in patients undergoing liver transplantation, in addition to their ability to predict AKI before creatinine alteration. Methods: A prospective cohort study was carried out at the Walter Cantídio University Hospital and Hospital São Carlos with patients who underwent liver transplantation in 2016. Clinical and epidemiological data were collected, as well as serial serum samples (T1: anesthesia induction, T2: anepatic fase and T3 : 2h post-reperfusion) for analysis of the biomarkers NGAL and Syndecan-1. Results: A total of 46 patients were included in the study, with a mean age of 54 years, of which 60% were male. AKI was observed in 24 cases (61.5%) in the first 7 days of hospitalization. The comparative analysis of the biomarkers in the first 7 days post-transplantation between the groups without and with AKI showed that the single measurement of syndecan-1 2h post reperfusion correlated with the occurrence of AKI (p <0.001). No isolated NGAL value correlated with the occurrence of AKI in the respective study, although the T3 / T2 ratio was related to the occurrence of AKI 7 days after hepatic transplantation. Conclusion: NGAL and Syndecan-1 biomarkers can predict the occurrence of AKI in patients undergoing liver transplantation prior to creatinine clearance. Key words: liver transplantation, NGAL, Syndecan-1, acute kidney injury.