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Renal Transplant Alıcılarında Transplant Sonrası Nötrofil-Lenfosit Oranı ve Trombosit-Lenfosit Oranı ile Graft Fonksiyonu Arasındaki İlişki

Year 2020, , 212 - 217, 30.12.2020
https://doi.org/10.18678/dtfd.764557

Abstract

Amaç: Bu çalışmanın amacı nötrofil-lenfosit oranı (NLO) ve trombosit-lenfosit oranı (TLO) ile böbrek nakli sonrası akut rejeksiyon arasındaki ilişkiyi değerlendirmektir.
Gereç ve Yöntemler: Ocak 2016 ile Ocak 2019 tarihleri arasında yürütülen bu geriye dönük çalışmaya ortanca yaşı 41 (aralık, 19-64) yıl olan toplam 36 yetişkin (33 erkek, 3 kadın) böbrek nakli alıcısı dahil edildi. Hastaların demografik özellikleri ve laboratuvar bulguları (nötrofil, lenfosit, trombosit, kreatinin, eGFR, serum ürik asit, C-reaktif protein) kaydedildi. Akut rejeksiyon Banff kriterlerine göre renal biyopsi ile tanımlandı.
Bulgular: On altı (%44,4) hastada akut rejeksiyon gelişti. NLO (ortanca 3,75’e karşı 1,99; p=0,001) ve TLO (ortanca 125,59’a karşı 99,23; p=0,008) değerleri akut rejeksiyon grubunda kontrol grubuna göre anlamlı olarak daha yüksekti. Eğri altındaki alan, NLO için 0,822 ve TLO için 0,759 olarak hesaplandı. Cut-off değer NLO için >2,5 (%75 duyarlılık ve %75 özgüllük) ve TLO için >108 (%81 duyarlılık ve %65 özgüllük) olarak belirlendi. Tek değişkenli analiz, NLO >2,5 (Odds Ratio (OR)=0,267; %95 Güven Aralığı (GA)=0,089-0,803; p=0,019) ve TLO >108 (OR=0,231; %95 GA=0,066-0,810; p=0,022) ile akut rejeksiyon arasında güçlü bir korelasyon olduğunu ortaya koydu.
Sonuç: Böbrek nakli hastalarında, yüksek NLO ve TLO değerleri ile akut rejeksiyon gelişimi arasında güçlü bir ilişki vardır. Basit, erişimi kolay, ucuz ve invaziv olmayan yöntemler olarak TLO ve özellikle NLO, transplant sonrası akut rejeksiyonu teşhis etmek için potansiyel testler olabilirler.

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References

  • Naranjo M, Agrawal A, Goyal A, Rangaswami J. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio predict acute cellular rejection in the kidney allograft. Ann Transplant. 2018;23:467-74.
  • Strom TB, Suthanthiran M. Prospects and applicability of molecular diagnosis of allograft rejection. Semin Nephrol. 2000;20(2):103-7.
  • Altunoren O, Akkus G, Sezal DT, Ciftcioglu M, Guzel FB, Isiktas S, et al. Does neutrophyl to lymphocyte ratio really predict chronic kidney disease progression? Int Urol Nephrol. 2019;51(1):129-37.
  • Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol. 2013;88(1):218-30.
  • Papa A, Emdin M, Passino C, Michelassi C, Battaglia D, Cocci F. Predictive value of elevated neutrophil-lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. Clin Chim Acta. 2008;395(1-2):27-31.
  • Erre GL, Paliogiannis P, Castagna F, Mangoni AA, Carru C, Passiu G, et al. Meta-analysis of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in rheumatoid arthritis. Eur J Clin Invest. 2019;49(1):e13037.
  • Seropian IM, Romeo FJ, Pizarro R, Vulcano NO, Posatini RA, Marenchino RG, et al. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as predictors of survival after heart transplantation. ESC Heart Fail. 2018;5(1):149-56.
  • Hogendorf P, Suska A, Skulimowski A, Rut J, Grochowska M, Wencel A, et al. Neutrophil-lymphocyte ratio and creatinine reduction ratio predict good early graft function among adult cadaveric donor renal transplant recipients. Single institution series. Pol Przegl Chir. 2018;90(2):28-33.
  • Cankaya E, Bilen Y, Keles M, Uyanik A, Bilen N, Aydinli B. Neutrophil-lymphocyte ratio is significantly decreased in preemptive renal transplant patients. Transplant Proc. 2015;47(5):1364-8.
  • Halazun KJ, Marangoni G, Hakeem A, Fraser SM, Farid SG, Ahmad N. Elevated preoperative recipient neutrophil-lymphocyte ratio is associated with delayed graft function following kidney transplantation. Transplant Proc. 2013;45(9):3254-7.
  • Solez K, Colvin RB, Racusen LC, Haas M, Sis B, Mengel M, et al. Banff 07 classification of renal allograft pathology: updates and future directions. Am J Transplant. 2008;8(4):753-60.
  • Ohtaka M, Kawahara T, Takamoto D, Mochizuki T, Ishida H, Hattori Y, et al. Neutrophil-to-lymphocyte ratio in renal transplant patients. Exp Clin Transplant. 2018;16(5):546-49.
  • Kazimoglu H, Uysal E, Dokur M, Gunerkan HR. Evaluation of the relationship between neutrophil lymphocyte ratio and the most common bacterial urinary tract infections after transplantation. Bratisl Lek Listy. 2019;120(2):161-5.
  • Turkmen K, Erdur FM, Guney I, Ozbiner H, Toker A, Gaipov A, et al. Relationship between plasma pentraxin-3, neutrophil-to-lymphocyte ratio, and atherosclerosis in renal transplant patients. Cardiorenal Med. 2012;2(4):298-307.
  • Turkmen K, Guney I, Yerlikaya FH, Tonbul HZ. The relationship between neutrophil-to-lymphocyte ratio and inflammation in end-stage renal disease patients. Ren Fail. 2012;34(2):155-9.
  • Ergin G, Deger SM, Kopru B, Derici U, Arinsoy T. High neutrophil-to-lymphocyte ratio predicts acute allograft rejection in kidney transplantation: a retrospective study. Turk J Med Sci. 2019;49(2):525-30.
  • Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD. The platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med. 2019;39(4):345-57.
  • Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340(6):448-54.
  • Choi DH, Kobayashi Y, Nishi T, Luikart H, Dimbil S, Kobashigawa J, et al. Change in lymphocyte to neutrophil ratio predicts acute rejection after heart transplantation. Int J Cardiol. 2018;251:58-64.
  • El-Sawy T, Belperio JA, Strieter RM, Remick DG, Fairchild RL. Inhibition of polymorphonuclear leukocyte-mediated graft damage synergizes with short-term costimulatory blockade to prevent cardiac allograft rejection. Circulation. 2005;112(3):320-31.
  • Kwon HM, Moon YJ, Jung KW, Park YS, Jun IG, Kim SO, et al. Neutrophil-to-lymphocyte ratio is a predictor of early graft dysfunction following living donor liver transplantation. Liver Int. 2019;39(8):1545-56.
  • Turkmen K, Erdur FM, Ozcicek F, Ozcicek A, Akbas EM, Ozbicer A, et al. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013;17(3):391-6.

The Post-Transplant Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Relation to Graft Function among Renal Transplant Recipients

Year 2020, , 212 - 217, 30.12.2020
https://doi.org/10.18678/dtfd.764557

Abstract

Aim: The aim of this study was to evaluate the association of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with acute rejection after kidney transplantation.
Material and Methods: A total of 36 adult renal transplant recipients (33 males, 3 females) with a median age of 41 (range, 19-64) years were included in this retrospective study conducted between January 2016 and January 2019. Data on patient demographics and laboratory findings (neutrophil, lymphocyte, platelet, creatinine, eGFR, serum uric acid and C-reactive protein) were recorded. Acute rejection was defined via renal biopsy in accordance with Banff criteria.
Results: Acute rejection occurred in 16 (44.4%) patients. NLR (median 3.75 vs. 1.99, p=0.001) and PLR (median 125.59 vs. 99.23, p=0.008) values were significantly higher in the acute rejection group than in the control group. Area under the curve was calculated to be 0.822 for NLR and to be 0.759 for PLR. Cut-off values were determined to be >2.5 (75% sensitivity and 75% specificity) for NLR and to be >108 (81% sensitivity and 65% specificity) for PLR. Univariate analysis revealed a strong correlation of acute rejection both with NLR >2.5 (Odds Ratio (OR)=0.267, 95% Confidence Interval (CI)=0.089-0.803, p=0.019) and PLR >108 (OR=0.231, 95% CI=0.066-0.810, p=0.022).
Conclusion: In kidney transplant patients, there is a strong relationship between high NLR and PLR values and the development of acute rejection. As simple, easy-to-access, inexpensive and non-invasive methods, PLR, and particularly NLR, may be potential tests to diagnose post-transplant acute rejection.

Project Number

-

References

  • Naranjo M, Agrawal A, Goyal A, Rangaswami J. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio predict acute cellular rejection in the kidney allograft. Ann Transplant. 2018;23:467-74.
  • Strom TB, Suthanthiran M. Prospects and applicability of molecular diagnosis of allograft rejection. Semin Nephrol. 2000;20(2):103-7.
  • Altunoren O, Akkus G, Sezal DT, Ciftcioglu M, Guzel FB, Isiktas S, et al. Does neutrophyl to lymphocyte ratio really predict chronic kidney disease progression? Int Urol Nephrol. 2019;51(1):129-37.
  • Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol. 2013;88(1):218-30.
  • Papa A, Emdin M, Passino C, Michelassi C, Battaglia D, Cocci F. Predictive value of elevated neutrophil-lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. Clin Chim Acta. 2008;395(1-2):27-31.
  • Erre GL, Paliogiannis P, Castagna F, Mangoni AA, Carru C, Passiu G, et al. Meta-analysis of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in rheumatoid arthritis. Eur J Clin Invest. 2019;49(1):e13037.
  • Seropian IM, Romeo FJ, Pizarro R, Vulcano NO, Posatini RA, Marenchino RG, et al. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as predictors of survival after heart transplantation. ESC Heart Fail. 2018;5(1):149-56.
  • Hogendorf P, Suska A, Skulimowski A, Rut J, Grochowska M, Wencel A, et al. Neutrophil-lymphocyte ratio and creatinine reduction ratio predict good early graft function among adult cadaveric donor renal transplant recipients. Single institution series. Pol Przegl Chir. 2018;90(2):28-33.
  • Cankaya E, Bilen Y, Keles M, Uyanik A, Bilen N, Aydinli B. Neutrophil-lymphocyte ratio is significantly decreased in preemptive renal transplant patients. Transplant Proc. 2015;47(5):1364-8.
  • Halazun KJ, Marangoni G, Hakeem A, Fraser SM, Farid SG, Ahmad N. Elevated preoperative recipient neutrophil-lymphocyte ratio is associated with delayed graft function following kidney transplantation. Transplant Proc. 2013;45(9):3254-7.
  • Solez K, Colvin RB, Racusen LC, Haas M, Sis B, Mengel M, et al. Banff 07 classification of renal allograft pathology: updates and future directions. Am J Transplant. 2008;8(4):753-60.
  • Ohtaka M, Kawahara T, Takamoto D, Mochizuki T, Ishida H, Hattori Y, et al. Neutrophil-to-lymphocyte ratio in renal transplant patients. Exp Clin Transplant. 2018;16(5):546-49.
  • Kazimoglu H, Uysal E, Dokur M, Gunerkan HR. Evaluation of the relationship between neutrophil lymphocyte ratio and the most common bacterial urinary tract infections after transplantation. Bratisl Lek Listy. 2019;120(2):161-5.
  • Turkmen K, Erdur FM, Guney I, Ozbiner H, Toker A, Gaipov A, et al. Relationship between plasma pentraxin-3, neutrophil-to-lymphocyte ratio, and atherosclerosis in renal transplant patients. Cardiorenal Med. 2012;2(4):298-307.
  • Turkmen K, Guney I, Yerlikaya FH, Tonbul HZ. The relationship between neutrophil-to-lymphocyte ratio and inflammation in end-stage renal disease patients. Ren Fail. 2012;34(2):155-9.
  • Ergin G, Deger SM, Kopru B, Derici U, Arinsoy T. High neutrophil-to-lymphocyte ratio predicts acute allograft rejection in kidney transplantation: a retrospective study. Turk J Med Sci. 2019;49(2):525-30.
  • Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD. The platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med. 2019;39(4):345-57.
  • Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340(6):448-54.
  • Choi DH, Kobayashi Y, Nishi T, Luikart H, Dimbil S, Kobashigawa J, et al. Change in lymphocyte to neutrophil ratio predicts acute rejection after heart transplantation. Int J Cardiol. 2018;251:58-64.
  • El-Sawy T, Belperio JA, Strieter RM, Remick DG, Fairchild RL. Inhibition of polymorphonuclear leukocyte-mediated graft damage synergizes with short-term costimulatory blockade to prevent cardiac allograft rejection. Circulation. 2005;112(3):320-31.
  • Kwon HM, Moon YJ, Jung KW, Park YS, Jun IG, Kim SO, et al. Neutrophil-to-lymphocyte ratio is a predictor of early graft dysfunction following living donor liver transplantation. Liver Int. 2019;39(8):1545-56.
  • Turkmen K, Erdur FM, Ozcicek F, Ozcicek A, Akbas EM, Ozbicer A, et al. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013;17(3):391-6.
There are 22 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Emel Isıktas Sayılar 0000-0002-8824-6560

Sıla Çelik 0000-0002-5419-8169

Muhammed Emir İnce 0000-0002-3372-1934

İhsan Ergün 0000-0003-2066-5512

Project Number -
Publication Date December 30, 2020
Submission Date July 6, 2020
Published in Issue Year 2020

Cite

APA Isıktas Sayılar, E., Çelik, S., İnce, M. E., Ergün, İ. (2020). The Post-Transplant Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Relation to Graft Function among Renal Transplant Recipients. Duzce Medical Journal, 22(3), 212-217. https://doi.org/10.18678/dtfd.764557
AMA Isıktas Sayılar E, Çelik S, İnce ME, Ergün İ. The Post-Transplant Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Relation to Graft Function among Renal Transplant Recipients. Duzce Med J. December 2020;22(3):212-217. doi:10.18678/dtfd.764557
Chicago Isıktas Sayılar, Emel, Sıla Çelik, Muhammed Emir İnce, and İhsan Ergün. “The Post-Transplant Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Relation to Graft Function Among Renal Transplant Recipients”. Duzce Medical Journal 22, no. 3 (December 2020): 212-17. https://doi.org/10.18678/dtfd.764557.
EndNote Isıktas Sayılar E, Çelik S, İnce ME, Ergün İ (December 1, 2020) The Post-Transplant Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Relation to Graft Function among Renal Transplant Recipients. Duzce Medical Journal 22 3 212–217.
IEEE E. Isıktas Sayılar, S. Çelik, M. E. İnce, and İ. Ergün, “The Post-Transplant Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Relation to Graft Function among Renal Transplant Recipients”, Duzce Med J, vol. 22, no. 3, pp. 212–217, 2020, doi: 10.18678/dtfd.764557.
ISNAD Isıktas Sayılar, Emel et al. “The Post-Transplant Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Relation to Graft Function Among Renal Transplant Recipients”. Duzce Medical Journal 22/3 (December 2020), 212-217. https://doi.org/10.18678/dtfd.764557.
JAMA Isıktas Sayılar E, Çelik S, İnce ME, Ergün İ. The Post-Transplant Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Relation to Graft Function among Renal Transplant Recipients. Duzce Med J. 2020;22:212–217.
MLA Isıktas Sayılar, Emel et al. “The Post-Transplant Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Relation to Graft Function Among Renal Transplant Recipients”. Duzce Medical Journal, vol. 22, no. 3, 2020, pp. 212-7, doi:10.18678/dtfd.764557.
Vancouver Isıktas Sayılar E, Çelik S, İnce ME, Ergün İ. The Post-Transplant Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Relation to Graft Function among Renal Transplant Recipients. Duzce Med J. 2020;22(3):212-7.