Urinary hepatocyte growth factor indicates ischemia/reperfusion injury after kidney transplantation

INTRODUCTION: Despite the development of immunosuppressive regimens in kidney transplantation, long‑term graft survival rates have not increased significantly. One of the causes of long‑term graft loss is ischemia‑reperfusion insult. Hepatocyte growth factor (HGF) is a regenerative factor produced in response to injury. OBJECTIVES: Our aim was to assess the effect of HGF and xanthine oxidase (indicators of ischemia/reperfusion insult) on early and late kidney function. PATIENTS AND METHODS: In 17 patients, HGF levels in urine and xanthine oxidase activity in blood were examined 1, 7, 14, 30 days, 3 and 6 months after kidney transplantation. We also measured 24‑hour diuresis and serum creatinine levels after transplantation. RESULTS: Urinary HGF levels were highest 1 day after transplantation. During the following week, it rapidly decreased and was maintained at similar levels in the later period. Creatinine at 1 day showed a positive correlation with urinary HGF levels at 1 day and at 3 months (R = 0.54, P <0.05 and R = 0.82, P <0.01, respectively). Creatinine at 7 days positively correlated with HGF levels at 6 months (R = 0.82, P <0.05). HGF levels at 1 day and at 6 months positively correlated with xanthine oxidase activity at 1 day (R = 0.73, P <0.001 and R = 0.77, P <0.02, respectively). A negative correlation was observed between HGF levels at 6 months and diuresis 1 and 7 days after transplantation (R = –0.99, P <0.00 001 and R = –0.77, P <0.05, respectively). CONCLUSIONS: Urinary HGF is a good marker of perioperative kidney damage and may affect long‑term graft function.