You will be presented with the full text of a biomedical research paper. Please write an abstract for this paper. Your response should include the abstract and no additional text.

Paper text:
in the previous issue of critical care , hollmen and colleagues   investigate the utility of a novel biomarker of acute kidney injury ( aki ) for the pre - harvest assessment of likely outcomes of kidney transplantation from deceased donors .
aki is a syndrome that is associated with a major burden of morbidity and mortality in a variety of high risk patient populations , many of them cared for by intensivists .
clinical and translational research in recent years has focused on improvements in the diagnostic and prognostic evaluation of aki to improve care .
validation of new systems for the diagnosis and staging of aki have been important advances , and the discovery and validation of novel biomarkers of aki that can achieve earlier diagnosis and improve prognostic stratification have been a more recent focus in the field .
one such marker is neutrophil gelatinase - associated lipocalin ( ngal ) , which is a 25-kda gelatinase - bound protein that was originally characterized in neutrophils . in recent years
, ngal has been shown to be produced in the kidney following ischemic or nephrotoxic injury in both animals and humans , and has clinical utility for the early or differential diagnosis and prognostic evaluation of aki [ 3 - 6 ] .
renal transplantation is a clinical setting of ischemia - reperfusion injury that includes many features of laboratory experimental models of aki , including the timed development of acute tubular necrosis ( atn ) , potentially permitting the use of agents for primary or secondary prophylaxis to prevent or ameliorate aki .
delayed graft function ( dgf ) caused by severe atn , defined by a requirement for dialysis during the initial post - transplant week , complicates postoperative management , and if prolonged ( > 14 days ) , adversely effects allograft survival .
the incidence of dgf is rising with the growing practice of accepting expanded criteria donors to increase transplantation rates .
there is a limited literature investigating the utility of ngal for the diagnostic and prognostic evaluation of aki in kidney transplantation .
hollmen and colleagues , also the authors of the paper commented on here , previously found that urine ngal from the recipient on the first post - transplant day was of moderate utility to predict dgf , particularly prolonged dgf that correlated with worse 1-year graft survival .
similarly , others have shown that a variety of biomarkers of renal tubular injury / damage [ 8 - 12 ] or serum cystatin c ( a marker of kidney function / glomerular filtration rate ( gfr ) )   can similarly diagnose aki secondary to dgf in the early post - transplant period better than a combination of the usual clinical parameters of kidney function ( serial monitoring of serum creatinine and urine output ) with known dgf risk factors ( ischemia times , and so on ) .
hollmen and colleagues   demonstrate that donor urine ngal ( but not serum ngal ) is similarly useful to help with the pre - harvest prediction of dgf after renal transplantation from deceased donors .
specifically , they studied pre - harvest serum and urine ngal levels in 99 consecutive , deceased donors , and followed the clinical courses of their 176 kidney recipients .
they found that high pre - harvest urine ngal levels were more common in those who developed prolonged dgf . in receiver operating characteristic ( roc ) curve analysis , donor urine ngal had poor utility for prediction of dgf ( area under the curve 0.595 ) or prolonged dgf ( area under the curve 0.616 ) .
however , increased donor urine ngal was a significant risk factor for prolonged dgf independent of other important predictors ( expanded criteria donor status and estimated gfr ) .
these findings have clear implications with regard to potentially improved assessment of deceased donor suitability for potential renal allograft donation .
furthermore , their findings augment the growing evidence - base suggesting the utility of biomarkers of kidney damage to provide additional diagnostic and prognostic information regarding the presence , severity , and likely course of aki in high - risk settings , beyond what can be discerned by the use of markers of renal function ( gfr and urine output ) alone .
such diagnostic and prognostic accuracy has the potential to significantly improve the clinical evaluation and management of aki , including aggressive resuscitation of patients with aki but no evidence of kidney damage ( ' prerenal ' , reversible renal hypoperfusion resulting in decreased gfr ) , and early initiation of dialysis in patients with evolving aki caused by severe atn ( based upon biomarker evidence of severe renal tubular damage ) .
thus , the emerging use of novel aki biomarkers of renal dysfunction and damage can offer the prospect of appropriate , early , goal - directed therapy of aki in high risk patients , including prompt reversal where possible , and aggressive renal support where necessary .
aki : acute kidney injury ; atn : acute tubular necrosis ; dgf : delayed graft function ; gfr : glomerular filtration rate ; ngal : neutrophil gelatinase - associated lipocalin .
ptm has received research support and honoraria for scientific advisory board activity and speaking engagements from abbott laboratories ; and research support and honoraria for scientific advisory board activity from alere medical .
ptm is also a consultant / scientific advisory board member for fast diagnostics and argutus medical .
acute kidney injury ( aki ) is a syndrome that is associated with a major burden of morbidity and mortality in a variety of high risk patient populations , many of them cared for by intensivists . 
 following renal transplantation , delayed graft function ( dgf ) caused by severe acute tubular necrosis ( atn ) , defined by a requirement for dialysis during the initial post - transplant week , complicates postoperative management , and if prolonged ( > 14 days ) , adversely affects allograft survival . 
 neutrophil gelatinase - associated lipocalin ( ngal ) and other novel biomarkers can detect aki earlier than serum creatinine , and can predict aki severity in high risk patient populations , including kidney transplant recipients . 
 hollmen and colleagues now demonstrate that elevated urine ngal in deceased kidney donors is a significant risk factor for prolonged post - transplant dgf in recipients . 
 these findings have clear implications with regard to potentially improved assessment of deceased donor suitability for potential renal allograft donation . 
 these findings are also consistent with the growing evidence that severe atn diagnosed by markedly elevated levels of aki biomarkers is a useful predictor of the requirement for acute renal replacement therapy in aki patients .