Improving long-term graft survival is a major challenge in kidney transplantation. Ischaemia-reperfusion
injury is a critical early allograft insult that enhances the risk of delayed graft function, which is common
in deceased-donor transplantation. Delayed graft function complicates the post-transplant management and
has a negative impact on both short and long-term outcomes. The development of effective interventions
to prevent and attenuate the injury caused by ischaemia-reperfusion is constricted by the limited ability of
early detection of kidney damage. In recent years, clinical and translational research has focused on improvements
in the diagnosis of acute kidney injury and provided prognostic information that is helpful in the
post-transplant care. Numerous biomarkers in kidney transplantation have been evaluated in the past
decade, but, so far, evidence to support their use in routine practice is limited. The purpose of this review
is to examine the current status of three biomarkers for early diagnosis and prognosis of delayed graft
function, namely urinary neutrophil gelatinase-associated lipocalin, oxidative stress and cystatin C. In addition,
the concept of a biomarker is addressed, as well as the existing challenges and perspectives for
developing a biomarker. This review discusses current literature and reflects the author’s own interpretation
and experience
