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Proenkephalin A 119-159 in kidney transplantation: a novel biomarker for superior tracking of graft function trajectories

Accurate assessment of graft function trajectories after kidney transplantation is essential for optimizing patient management. Slow graft function (SGF) and delayed graft function (DGF) are associated with impaired recovery, yet current diagnostic tools lack granularity for timely risk stratificati...

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Main Authors: Benning, Louise (Author) , Reineke, Marvin (Author) , Rodrigues, Camila Eleuterio (Author) , Kälble, Florian (Author) , Speer, Claudius (Author) , Sommerer, Claudia (Author) , Mahler, Christoph (Author) , Schmitt, Felix (Author) , Mieth, Markus (Author) , Zeier, Martin (Author) , Michalski, Christoph (Author) , Mehrabi, Arianeb (Author) , Hartmann, Oliver (Author) , Zorn, Markus (Author) , Anker, Sophie (Author) , Czock, David (Author) , Weigand, Markus A. (Author) , Endre, Zoltan (Author) , Morath, Christian (Author) , Nußhag, Christian (Author)
Format: Article (Journal)
Language:English
Published: 22 May 2025
In: Transplant international
Year: 2025, Volume: 38, Pages: 1-11
ISSN:1432-2277
DOI:10.3389/ti.2025.14366
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3389/ti.2025.14366
Verlag, kostenfrei, Volltext: https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2025.14366/full
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Author Notes:Louise Benning, Marvin Reineke, Camila Eleuterio Rodrigues, Florian Kälble, Claudius Speer, Claudia Sommerer, Christoph F. Mahler, Felix C.F. Schmitt, Markus Mieth, Martin Zeier, Christoph Michalski, Arianeb Mehrabi, Oliver Hartmann, Markus Zorn, Sophie C. Anker, David Czock, Markus A. Weigand, Zoltan Endre, Christian Morath and Christian Nusshag
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Summary:Accurate assessment of graft function trajectories after kidney transplantation is essential for optimizing patient management. Slow graft function (SGF) and delayed graft function (DGF) are associated with impaired recovery, yet current diagnostic tools lack granularity for timely risk stratification. Proenkephalin A 119-159 (penKid) may improve graft function assessment, enhancing risk stratification for SGF, DGF, and associated outcomes. This prospective study evaluated 159 kidney transplant recipients at Heidelberg University Hospital to compare plasma penKid levels with current risk-indicators for poor (functional) graft trajectories. Validation was conducted using an independent transplant cohort from Sydney. Clinical relevance of biomarker-indicated changes in graft function was assessed using multivariable regression models and AUROC analyses. From day one post-transplant, penKid outperformed serum creatinine (SCr) in identifying functional trajectories associated with DGF (AUROC penKid: 0.87 vs. SCr: 0.56) and differentiated SGF from DGF (AUROC penKid: 0.79 vs. SCr: 0.33) up to eight days earlier. PenKid further demonstrated superior granularity in assessing DGF severity and 30-day outcomes. After adjustment for common risk factors, penKid remained the strongest risk stratifier for all tested outcomes. PenKid is a superior biomarker for earlier assessment of graft function trajectories, offering potential to enhance personalized care and clinical trial designs in kidney transplantation.
Item Description:Gesehen am 23.10.2025
Physical Description:Online Resource
ISSN:1432-2277
DOI:10.3389/ti.2025.14366

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