Donor Urinary C5a Levels Independently Correlate With Posttransplant Delayed Graft Function

Background Accumulating evidence implicates the complement cascade as pathogenically contributing to ischemia-reperfusion injury and delayed graft function (DGF) in human kidney transplant recipients. Building upon observations that kidney injury can initiate in the donor before nephrectomy, we tested the hypothesis that anaphylatoxins C3a and C5a in donor urine prior to transplantation associate with risk of post-transplant injury. Methods We evaluated the effects of C3a and C5a in donor urine on outcomes of 469 deceased donors and their corresponding 902 kidney recipients in a subset of a prospective cohort study. Results We found a 3-fold increase of urinary C5a concentrations in donors with stage 2 and 3 AKI compared donors without AKI (p

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