Table 2.
Newer methods in the literature to identify DGF and their diagnostic strengths
| Year of | STARD score | |||||
|---|---|---|---|---|---|---|
| First author | publication | Description of the test | Test characteristics | N | Gold standard/definition used | (max. score 25) |
| Preidler [46] | 1996 | Gadolinium-enhanced MR imaging | Not reported | 24 | Allograft biopsy showing ATN and no rejection | 17 |
| Freedland [19] | 2001 | EPRF <210 mL/min/ 1.7 m2 | Sensitivity 100%, specificity 69% | 41 | Need for dialysis within the first 10 days | 11 |
| Norio [47] | 2001 | Systemic and renal vein eicasanoids | Not reported | 62 | Failure of serum creatinine to decrease and the need for dialysis during the first week | 7 |
| Parikh [48] | 2004 | Urine IL-18 in first 24 h >500 pg/mg | Sensitivity 85%, specificity 88% AUC 0.95 | 22 | Serum creatinine decreasing by <1 mg/dL/day for three consecutive days in the first 5 days after transplant or the need for hemodialysis in the first week post-transplantation and a urine sediment characteristic of ATN, i.e. muddy brown broad granular casts and renal tubular epithelial cells | 13 |
| Avihingsanon [38] | 2005 | TNF-α gene expression in intra-operative biopsy | R2 = 0.68 (P < 0.001) AUC 0.87 | 75 | Need for dialysis during the first week post-transplantation in the absence of AR, vascular complications, or urinary tract obstruction | 8 |
| Boom [45] | 2005 | Presence of manganese superoxide in distal tubules of renal allograft | Sensitivity 76% (for the absence of DGF) | 40 | Failure of the graft to reduce serum creatinine concentration by >10% over three consecutive days for more than 1 week after transplantation | 11 |
| Mishra [49] | 2006 | NGAL staining in an allograft biopsy | Correlation between NGAL staining and post-operative creatinine R = 0.86 | 25 | Need for dialysis in the first week after transplant | 12 |
| Parikh [33] | 2006 | Urine NGAL on Day 0 > 1000 ng/mg and IL-18 on Day 0 > 500 pg/mg | Sensitivity 90%, specificity 83%, AUC 0.9 | 53 | Need for dialysis in the first week after transplant. | 15 |
| Sadeghi [50] | 2006 | Pre-transplant soluble IL-6R of 35 000 pg/mL | Sensitivity 77%, Specificity 64%* | 98 | Biopsy-proven ATN | 9 |
| Mehta [34] | 2006 | CALCA hypermethylation | Trend toward increased aberrant hypermethylation in patients with ATN versus rejection | 25 | Biopsy-proven ATN | 13 |
TNF: tumor necrosis factor; AUC: area under the curve; AR: acute rejection; NGAL: neutrophil gelatin-associated lipocalin; IL: interleukin; ATN: acute tubular necrosis; MR: magnetic resonance; EPRF: estimated renal plasma flow; CALCA: calcitonin gene.
*AUC mentioned as significant but value not given.