Franny Jongbloed

209 8 BENEFICIAL EFFECTS OF A PREOPERATIVE DIET Table 3. Postoperative outcome and complications in kidney transplant recipients in the first 14 days after surgery Parameter CCPR (n=15) Control (n=20) P- value Urine production during surgery (yes/no (%)) 1/15 (7%) 5/20 (25%) 0.135 ATN on MAG3 scan (yes/no) 2/15 (7%) 6/20 (30%) 0.209 Delayed graft function (yes/no) 0/15 (0%) 0/20 (0%) 1.000 Slow graft function (yes/no) 0/15 (0%) 5/20 (25%) 0.020 Acute rejection, biopsy-proven (yes/no) 1/15 (7%) 8/20 (40%) 0.013 Hospital stay (days) 13 ± 1 14 ± 1 0.556 Any complication (yes/no) 10/5 (73%) 16/4 (75%) 0.445 Clavien-Dindo score (0-4) 1.5 ± 0.3 1.5 ±0.2 0.986 Tacrolimus level POD3 15.0 ± 1.8 10.6 ± 1.4 0.065 Tacrolimus level POD5 14.5 ± 1.8 10.8 ± 1.2 0.094 Tacrolimus level POD10 (µg/L) 12.7 ± 1.5 10.6 ± 1.0 0.251 Values are depicted as median ± interquartile range. ATN = acute tubular necrosis; MAG3 = renal scintigraphy scan; POD = postoperative day; Clavien-Dindo = official classification score for postoperative surgical complications. CCPR = combined calorie and protein restriction. Significance is considered at P< 0.05 and is depicted in bold. Gender based differences Since baseline characteristics between the two study groups differed concerning gender, a subgroup analysis stratified by gender was performed. In the female donors, a consistent trend in improved relative creatinine clearance and eGFR was observed for prolonged periods after POD1 (Figure S3). In male donors, relative creatinine concentrations were significantly improved in the CCPR group at POMo1 ( P= 0.009) and POMo3 ( P= 0.022) (Figure S4). Division based on gender of the donors showed for female CCPR kidneys a consistent trend for improved relative creatinine and eGFR that did not reach statistical significance (Figure S3F and S3H). The most pronounced CCPR-related differences in the kidney transplant recipients were observed in kidneys of the male donors; absolute and relative creatinine clearance was improved in the recipients of the male CCPR donors as from POD1 until POD7 (Figure S4E-H). Comparison of the transcriptome in kidneys from control or CCPR diet To get a more detailed insight into the main differences between both groups of donors that might help to explain the clinical impact of the CCPR diet, we performed a full genome expression profile analysis of the kidneys using renal biopsies fromall 20 donors taken during transplantation before implantation and directly after cold-ischemia. Moreover, several other gene expression profiling studies have been published, providing an interesting basis