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We aim to evaluate the pattern of urine and plasma neutrophil gelatinase-associated lipocalin (NGAL) elevation during the perioperative period of LT and to assess it as a prognostic marker for AKI progression, need for dialysis and mortality.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We assessed NGAL levels before induction of anesthesia, after portal reperfusion and at 6, 18, 24, and 48\u2009h after surgery. Patients were monitored daily during the first week after LT.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of 100 enrolled patients undergoing liver transplant, 59 developed severe AKI based on the KDIGO serum creatinine (sCr) criterion; 34 were dialysed, and 21 died within 60\u2009days after LT. Applying a cut-off value of 136\u2009ng\/ml, UNGAL values 6\u2009h after surgery was a good predictor of AKI development within 7\u2009days after surgery, having a positive predictive value (PPV) of 80% with an AUC of 0.76 (95% CI 0.67\u20130.86). PNGAL at 18\u2009h after LT was also a good predictor of AKI in the first week, having a PPV of 81% and AUC of 0.74 (95% CI 0.60\u20130.88). Based on PNGAL and UNGAL cut-off criteria levels, time to AKI diagnosis was 28 and 23\u2009h earlier than by sCr, respectively. The best times to assess the need for dialysis were 18\u2009h after LT by PNGAL and 06\u2009h after LT by UNGAL.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In conclusion, the plasma and urine NGAL elevation pattern in the perioperative period of the liver transplant can predict AKI diagnosis earlier. UNGAL was an early independent predictor of AKI development and need for dialysis. Further studies are needed to assess whether the clinical use of biomarkers can improve patient outcomes.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>Registered at Clinical Trials (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>) in March 24th, 2014 by title \u201cAcute Kidney Injury Biomarkers: Diagnosis and Application in Pre-operative Period of Liver Transplantation (AKIB)\u201d and identifier NCT02095431, retrospectively registered.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12882-019-1566-9","type":"journal-article","created":{"date-parts":[[2019,10,15]],"date-time":"2019-10-15T12:47:42Z","timestamp":1571143662000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Early detection of acute kidney injury in the perioperative period of liver transplant with neutrophil gelatinase-associated lipocalin"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3930-1081","authenticated-orcid":false,"given":"Camila","family":"Lima","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana Bertocco","family":"de Paiva Haddad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia Donado Vaz","family":"de Melo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Marcelo","family":"Malbouisson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian Pires Freitas","family":"do Carmo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Augusto Carneiro","family":"D\u2019Albuquerque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etienne","family":"Macedo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,15]]},"reference":[{"key":"1566_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/bja\/aeu556","volume":"10","author":"A Hilmi","year":"2015","unstructured":"Hilmi A, Damian D, Al-Khafaji A, Planinsic R, Boucek C, Sakai T, et al. 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PMID: 24266830.","DOI":"10.2217\/bmm.13.91"}],"container-title":["BMC Nephrology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12882-019-1566-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12882-019-1566-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12882-019-1566-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T23:05:46Z","timestamp":1602630346000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcnephrol.biomedcentral.com\/articles\/10.1186\/s12882-019-1566-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,15]]},"references-count":42,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["1566"],"URL":"https:\/\/doi.org\/10.1186\/s12882-019-1566-9","relation":{},"ISSN":["1471-2369"],"issn-type":[{"value":"1471-2369","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,15]]},"assertion":[{"value":"20 December 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 September 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 October 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All patients signed an informed consent according to the protocol approved by the Research Ethics Committee, Hospital das Clinicas, Faculty of Medicine, University of S\u00e3o Paulo with number 266581 and Brazil platform CAAE 06636513400000068. The protocol is available on  with identifier NCT02095431.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that there is no conflict of interest regarding the publication of this paper.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"367"}}