Open Access Highly Accessed Research article

Urine IL-18, NGAL, IL-8 and serum IL-8 are biomarkers of acute kidney injury following liver transplantation

Jeffrey C Sirota1, Angela Walcher1, Sarah Faubel1, Alkesh Jani1, Kim McFann1, Prasad Devarajan2, Connie L Davis3 and Charles L Edelstein1*

Author Affiliations

1 Division of Renal Diseases and Hypertension, University of Colorado at Denver Health Sciences Center, Box C281, 12700 East 19th Ave, Aurora, CO 80262, USA

2 Division Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 7022, Cincinnati, OH, USA

3 Division of Nephrology, Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA

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BMC Nephrology 2013, 14:17  doi:10.1186/1471-2369-14-17

Published: 17 January 2013



AKI is common following liver transplantation and is associated with significant morbidity and mortality. Biomarkers of AKI have not been well established in this setting but are needed to help guide patient care and facilitate development of novel therapeutics.


Serum creatinine, cystatin C, IL-6, and IL-8 and urine IL-18, NGAL, IL-6, and IL-8 were measured before and within 24 hours after liver transplantation in 40 patients. AKI was defined as a ≥50% sustained increase in creatinine above pre-operative values occurring within 24 hours of transplantation and persisting for at least 24 hours.


Seven patients met criteria for AKI (17.5%), with mean creatinines of 0.81 mg/dL pre-operatively and 1.75 mg/dL post-operatively. While pre-operative biomarker levels in patients with AKI were similar to those in patients without AKI, differences were seen between the groups with regard to median post-operative serum IL-8 (pg/mL) (242.48 vs. 82.37, p = 0.0463) and urine NGAL (ng/mL) (386.86 vs. 24.31, p = 0.0039), IL-6 (pg/mL) (52 vs. 7.29, p=0.0532), IL-8 (pg/mL) (14.3 vs. 0, p = 0.0224), and IL-18 (pg/mL) (883.09 vs. 0, p = 0.0449). The areas under receiver operating characteristic (ROC) curves were 0.749 for urine IL-18, 0.833 for urine NGAL, 0.745 for urine IL-6, 0.682 for serum IL-6, 0.773 for urine IL-8, and 0.742 for serum IL-8. Post-operative cystatin C was not significantly different between AKI and no AKI groups.


Serum IL-8 and urine IL-18, NGAL, IL-6, and IL-8 are elevated in AKI within the first 24 hours following liver transplantation.

Biomarkers; Acute kidney injury; Liver transplantation