Interpretation of LDH Values after Kidney Transplantation

Kidney transplantation is the gold-standard therapy for end-stage renal disease. However, in the early postoperative period following allograft kidney transplantation, insufficient graft function presents a diagnostic challenge to clinicians. Ischemic damage to the graft and/or an early autoimmune r...

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Bibliographic Details
Published inJournal of clinical medicine Vol. 13; no. 2; p. 485
Main Authors Sándor, Zoltán, Katics, Dorottya, Varga, Ádám, Kalmár Nagy, Károly, Szakály, Péter
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 01.01.2024
Subjects
Antigens
Antithymocyte globulin
Care and treatment
Chronic kidney failure
Complications
Creatinine
Diagnosis
Graft rejection
Health aspects
Hemodialysis
Immune system
Ischemia
Kidney diseases
Kidney transplants
Kidneys
Laboratories
Lactate dehydrogenase
Measurement
Mortality
Patient outcomes
Patients
Peritoneal dialysis
Risk factors
Steroids
Surgery
Transplantation
Urine
Hungary
elevated lactate dehydrogenase
early acute rejection diagnosis
kidney transplantation
delayed graft function vs. acute rejection
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Summary:Kidney transplantation is the gold-standard therapy for end-stage renal disease. However, in the early postoperative period following allograft kidney transplantation, insufficient graft function presents a diagnostic challenge to clinicians. Ischemic damage to the graft and/or an early autoimmune rejection may cause a decrease in function. Ischemic damage is a benign and transient condition, while acute immune rejection requires immediate therapy. A kidney graft ultrasound may produce a false negative result, and graft biopsy is invasive and slow to return results. Serum lactate dehydrogenase (LDH) is under examination as a possible tool for differential diagnosis between ischemic damage and immune rejection. Herein, we analyze the continuous lab results of four patients in the early post-transplantation period, showing patterns correlating with different clinical outcomes and prognoses. In our experience, a persistent elevated LDH accompanies ischemic damage. Immune rejection was, however, associated with a decrease in LDH. Hemodialysis was not a confounding factor, while packed red blood cell transfusion caused severe diagnostic problems.
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ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13020485