الفهرس 
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Abstract
The study was conducted on seventy patients with end-stage renal disease with one or more risk factor for developing delayed graft function undergoing kidney transplantation from living donors attending the renal transplantation clinic at Ain shams University specialized Hospital (ASUSH), International medical center and Nile Badrawi specialized hospital in Egypt from May 2016 to July 2019 reviewed for eligibility criteria to be enrolled at our study which determined the sample size. These patients entered the run-in phase of the study and after exclusion of twenty-nine patients based on the exclusion criteria and developed of serious complications in the early post-operative period. Forty one patients were eligible and assigned into two groups according to the correlation with the serum creatinine levels in the first two days post transplantation after signed informed consent for participation in our study into group 1 (DGF group) where the patients developed DGF post-transplant (n=19) and group 2 (NGF group) where the patients didn’t develop DGF post-transplant (n=22) To evaluate the diagnostic value of Plasmatic Villin-1 in the prediction of early graft dysfunction in kidney transplant recipients among Egyptian population.
Serum samples were collected at different points starting at the time of declamping (zero level) and 1st, 3rd, 5th, 7th, 12th, 24th, 48th, 72th, 96th and 120th hour post declamping for measurement of plasmatic villin-1 levels by ELISA and to correlate them with the serum creatinine levels at the same points.
Regular follow up visits were scheduled at the nephrology and renal transplantation clinics for 2 years to establish the incidence of rejection in both groups guided with rising serum creatinine and renal biopsy-based diagnosis then another serum sample was collected for plasmatic villin-1 measurement.
Two additional groups added to our study while processing the results to establish normal range of Plasmatic villin-1 in healthy adults and End stage renal disease patients (130 for each group classified according to their gender into two subgroups).
We concluded that Plasmatic villin-1 is a promising novel biomarker for detection of early graft dysfunction in kidney transplant recipients from our statistical analysis of the study data which compared the plasmatic villin-1 levels between both groups at different points with statistically significant differences were noted between both groups.
As regard the time of the rise of the plasmatic villin-1 level, it started to rise above the reference range of the plasmatic villin-1 in the ESRD patients at the 5th hour post declamping while the peak of the plasmatic villin-1 level were at the 7th hour post declamping.
The incidence of rejection was more in the DGF group in comparison to the NGF group with a highly statistically significant difference between both groups which also has been noted in the comparison between the two groups as regard the intraoperative and post-operative course (Instant UOP, Need for post-operative dialysis, intra and postoperative complications) which is higher in the DGF groups.
Also, the mean of the urine output volume in the first 2 days post-transplant was found to be more in the DGF groups’ recipients in comparison to NGF group, these results were found to be statistically significant between both groups which have also been noted in the variation between the both groups as regard the final cross match results.
As regard the plasmatic villin-1 in normal Population, the reference range guide was from 0.08 and 0.35 ng\ml in males and from 0.055 to 0.35 ng\ml in females with no significant difference between the them while from 0.38 and 1.4 ng\ml in males and from 0.28 to 1.1 ng\ml in females with a significant difference between the both gender in the ESRD patients.
The plasmatic villin-1 level didn’t show a significant rise beyond the reference range guide of the plasmatic villin-1 in the normal population when the serum samples withdrawn at the time of established graft rejection.
we didn’t find any statistically differences in the prevalence of hypertension, diabetes and other comorbidities between both groups in the recipients nor the donors and also as regard the comparison between the two groups as regard the demographic data, duration on dialysis pre-transplantation, previous blood transfusion and initial PRA between both groups.