Recipient Pre-Operative Neutrophil Lymphocyte Ratio Better Predicts Delayed Graft Function than Platelet Lymphocyte Ratio in Donation after Brain Death Kidney Transplantation

Abstract

Background: Neutrophil lymphocyte Ratio (NLR) and Platelet lymphocyte Ratio (PLR) are an indicator of the status of inflammation. The objective of this study was to evaluate the relationship between recipient pre-operative Neutrophil lymphocyte Ratio (NLR) and Platelet lymphocyte Ratio (PLR) with delayed graft function in the kidney transplant patient.
 Methods: The preoperative full blood count, data regarding patient demographics and postoperative graft function was retrospectively evaluated from the database of our institution. All statistical calculations were carried out using SPSS 20.0 version (SPSS Inc., Chicago, IL, USA). A p-value<0.05 was considered statistically significant.
 Results: 289 patients were included in this study. DGF occurred in 33 cases. Elevated preoperative NLR had a sensitivity of 75.75% and specificity of 76.56% whereas elevated preoperative PLR had a sensitivity of 72.72% and specificity of 58.20% for predicting DGF. The area under the ROC curve was found to be 0.762 and 0.655 for NLR and PLR, respectively. Multivariate analysis showed NLR>3.5 and PLR>120 independently responsible for DGF.
 Conclusion: Recipient preoperative NLR and PLR can predict the occurrence of DGF following DBD renal transplantation. In addition, NLR is better than PLR in predicting DGF. DGF prolongs the total ICU and in-hospital stay.