Purpose: There are lots of studies about inflammatory situation, especially focused on the role of IL-6, in early and late periods of renal transplantation. Midkine is an anti-apoptotic protein. Nowadays, extensive studies have been carried out on the role of this molecule in certain diseases. In this study, role of midkine as a marker of inflammation was investigated in patients before and after renal transplantation. Methods: In this prospective and observational study, inflammatory response was examined in adult patients underwent kidney transplantation from living donors. Serum and plasma samples were taken from all patients before the initiation of immunosuppressive therapy and two months after the operation. hsCRP, IL-6, TNF-alpha and midkine levels were studied from the samples. Results: 16 women and 25 men were enrolled in the study (the average age: 37.32 ± 11.72 years). All patients were under triple immunosuppressive therapy consisting of tacrolimus, mycophenolate mofetil and steroids. In the early postoperative period, acute rejection in two patients and hematoma in one patient were detected. Midkine levels showed a statistically significant increase 2 months after transplantation (p<0,001), whereas hsCRP, IL-6 and TNF-alpha levels did not change significantly.Table: No Caption available.Midkine showed correlation both with hsCRP (r=0,41, p=0,004) and IL-6 (r=0,58, p<0,001) levels at baseline. IL-6 was correlated with midkine (r=0,388, p=0,012), hsCRP (r=0,41, p=0,007) and TNF-alpha (r=0,348, p=0,026) at 2 months after the transplantation but there was no any correlation between midkine and other inflammatory parameters. Gender, plasma glucose and hemoglobin levels, pretransplant dialysis modality, presence of comorbidity had no affect on midkine levels. Conclusion: Midkine maybe a good marker of inflammation in both pre- and post-transplant period. In addition it does not influenced by some important confounding parameters.