Abstract

Background: Neutrophils are mediators of ischemia/reperfusion (I/R) injury following kidney transplantation (KTx). Leukocyte elastase complex with α[sub]1[/sub]-protease inhibitor (LE-α[sub]1[/sub]-PI) is a neutrophils degranulation marker. The study's aim was to evaluate LE-α[sub]1[/sub]-PI as marker of I/R kidney damage and to look for a correlation between leukocyte activation and posttransplant complications.
Material/Methods: The study was performed on 24 kidney graft recipients from the deceased donors. Plasma and urine LE-α[sub]1[/sub]-PI were analyzed 4 times in the first week after KTx (in postoperative (PO) days 1, 3, 7) and in a distant period after KTx. This was done by ELISA test.
Results: Peak of plasma LE-α1-PI complex level was on 1[sup]st[/sup] day after KTx and it was significantly higher than on 3[sup]rd[/sup] and 7[sup]th[/sup] PO days, as well as in a distant measurement (p<0.001; p<0.0001; p<0.001 respectively). The highest urine LE-α1-PI was observed on 3[sup]rd[/sup] PO day. Plasma and urine LE-α[sub]1[/sub]-PI on 1[sup]st [/sup]PO day was higher in DGF patients than in patients with IGF (p<0.02; p<0.0007 respectively). Significantly higher urine LE-α[sub]1[/sub]-PI excretion on 1[sup]st[/sup] PO day was observed in patients with longer cold ischemia time (CIT) - p<0.007. In patients with an early graft rejection urine LE-α[sub]1[/sub]-PI on 1[sup]st[/sup] and 7[sup]th[/sup] PO day was greater than in no-rejection group (p<0.009; p<0.04 respectively).
Conclusions: Our study is a presentation of non-invasive measurement of
neutrophils activation after KTx. It demonstrates a strong correlation between
test results: LE-α[sub]1 [/sub]-PI complex level and kidney graft function.

Keywords: Ischemia reperfusion injury, Kidney Transplantation