title: Low serial serum neopterin does not predict low risk for chronic renal graft rejection.
abstract: Research has provided new and potent immunosuppressants which can potentially stop ongoing rejection. Subclinical rejection is a particular problem in the pediatric age group and early identification of children at risk is of the utmost importance. Neopterin has been previously shown to be a non-specific but sensitive marker for immunologic activity. In this study we hypothesized that low serum neopterin in the 1st year after transplantation predicts a low risk of chronic rejection. We retrospectively analyzed serial neopterin data obtained beyond the early postoperative period in 21 children and correlated the peak and average with glomerular filtration rate (GFR) loss during the subsequent years (P = 0.63, NS, r = 0.10). Our results show that serum neopterin did not differ between the majority of children who developed chronic transplant dysfunction and children with stable transplant function beyond the early post-transplant period. Thus serum neopterin failed to delineate a low-risk population who might be spared more invasive diagnostic procedures such as protocol biopsy.
authors.affiliation: Universitätsklinik für Kinder- und Jugendheilkunde, AKH Wien, Währinger Gürtel 18-20, 1090 Vienna, Austria.
authors.forename: T
authors.initials: T
authors.lastname: Müller
authors.forename: A
authors.initials: A
authors.lastname: Orgler
authors.forename: B
authors.initials: B
authors.lastname: Bidmon
authors.forename: K
authors.initials: K
authors.lastname: Arbeiter
authors.forename: E
authors.initials: E
authors.lastname: Balzar
authors.forename: D
authors.initials: D
authors.lastname: Ruffingshofer
authors.forename: C
authors.initials: C
authors.lastname: Aufricht
mesh_terms: D002648:Child; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000209:etiology*; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D016030:Kidney Transplantation; D008297:Male; D019798:Neopterin / Q000097:blood*; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D019798:Neopterin; D003404:Creatinine