Pretransplantation soluble adhesion molecule expression predicts outcome after living donor renal transplantation.
OBJECTIVE
Occult pretransplantation systemic inflammation will identify patients at risk for poor outcomes after renal transplantation.


METHODS
Retrospective cohort study. Adhesion molecule levels were measured in pretransplantation serum samples from 86 recipients. Univariate and multivariate analyses were conducted to assess a possible correlation between serum adhesion molecule level and outcome.


METHODS
University referral center.


METHODS
Allograft rejection and survival.


RESULTS
Patients with low levels of vascular cell adhesion molecule 1 had less graft rejection (P=.007). Low levels of vascular cell adhesion molecule 1 independently predicted decreased rejection (relative risk, 0.17; P=.01), and high levels of vascular cell adhesion molecule 1 independently predicted graft loss (relative risk, 3.83; P=.02). Similar correlations were observed for intercellular adhesion molecule 1.


CONCLUSIONS
Decreased pretransplantation adhesion molecule expression correlates with less rejection, and increased levels correlate with graft loss. Assessment of pretransplantation inflammatory status may be useful in optimizing immunosuppression therapy.
Perez
Richard V
RV
Department of Surgery, Division of Transplant Surgery, University of California-Davis Medical Center, Sacramento 95817, USA. rvperez@ucdavis.edu
Huang
Charles Q
CQ
Johnson
Jeremy R
JR
Gallay
Brian J
BJ
Gandhi
Mehul M
MM
McVicar
John P
JP
Troppmann
Christoph
C
D000328:Adult; D000368:Aged; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006084:Graft Rejection / Q000097:blood; D006085:Graft Survival; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D018799:Intercellular Adhesion Molecule-1