Retrospective Analysis of Monocyte Distribution Width in Kidney Transplantation

Background: A few reports have been published about monocyte/macrophages play a role in transplantation.Monocyte distribution width (MDW) is known as new screening indicator in sepsis.MDW is not reported yet in kidney transplantation (KT).We aimed to analyze MDW level with donor type (DT) and HLA antibody status and to evaluate correlations between MDW and other laboratory parameters in KT recipients.Methods: From April 2019 to July 2022, a total of 64 KT recipients with underwent deceased-donor (DD, n=37) and living-donor (LD, n=27) KTs in Eunpyeong St. Mary's Hospital.Panel reactive antibody (PRA), flow cytometric cross-match (FXCM), and initial MDW level according to DT (DD/LD) and DSA (DSA+[n=57]/DSA-[n=5]) were analyzed.A total of 645 consecutive MDW levels from 64 KT recipients were analyzed to evaluate correlations between MDW levels and other laboratory parameters; white blood cell (WBC), neutrophil (N), lymphocyte (L), N/L ratio (NLR), monocyte (M), eosinophil (E), basophil (B), C-reactive protein (CRP), creatinine (Cr), modification of diet in renal disease-estimated glomerular filtration rate (MDRD-eGFR), and chronic kidney disease epidemiology collaboration-eGFR (CKD-EPI-eGFR).Results: Initial median MDW level (interquartile range) was higher in DD than in LD; DD vs. LD (17.1 vs. 16.6) and was higher in DSA+ than in DSA-(17.5 vs. 16.8).In 645 consecutive MDW levels, MDW showed significant negative correlations with WBC, L, N, M, MDRD-eGFR, and CKD-EPI-eGFR (all P<0.05) except for NLR, E, B, CRP, and Cr.Conclusions: This is the first study to analyze MDW level in KT.MDW level was a trend to be higher in DD-KT and DSA+ KT groups.In addition, MDW level is significantly correlated with both MDRD-eGFR, and CKD-EPI-eGFR.Although the further study is needed, MDW will be an effect on the kidney function in KT recipients.