The following is the summary of “Dynamic changes of neutrophil-to-lymphocyte ratio in brain-dead donors and delayed graft function in kidney transplant recipients” published in the November 2022 issue of Renal failure by Zhang, et al.

A simple indicator of inflammation is the neutrophil-to-lymphocyte ratio (NLR). Their   study’s primary objective was to examine whether or if a non-specific lymphoid receptor (NLR) alteration in a brain-dead donor was associated with delayed graft function (DGF) in kidney transplant recipients. Researchers looked back at information from 102 adult brain-dead donors and the 199 people who received kidneys from them (between 2018 and 2021). 

Investigators found ΔNLR by deducting the NLR from before we began brain death evaluation from the NLR before surgery. Donor NLR improvement was measured as (ΔNLR>0). Following transplantation, DGF was found in 44 (22%). The odds of developing DGF in recipients increased with increasing donor NLR (OR 2.8, 95% CI 1.2 6.6; P=.018), and this association persisted after adjusting for covariates such as body mass index, hypertension, diabetes, and cardiac arrest (OR 2.6, 95% CI 1.0 6.4; P=.040). Donor NLR lost its independent correlation with DGF when acute kidney injury (AKI) was added in the multivariable analysis, although AKI remained an independent risk factor of recipient DGF (OR 4.5, 95% CI 2.7 7.6; P<.001). 

Increasing donor NLR (0.625, P=.015) and AKI alone (0.859, P<.001) were both poor predictors of DGF, but their combination (0.873) was much better. Predicting post-transplant DGF using dynamic changes in donor NLR shows promise. It will help doctors spot kidney transplant dysfunction early on so it can be treated effectively. The novel biomarker must be confirmed in major research before it can be widely used.