High pre-transplant soluble CD30 levels are predictive of the grade of rejection.
In renal transplantation, serum soluble CD30 (sCD30) levels in graft recipients are associated with increased rejection and graft loss. We investigated whether pre-transplant sCD30 concentrations are predictive of the grade of rejection. Pre-transplant sera of 51 patients with tubulointerstitial rejection (TIR), 16 patients with vascular rejection (VR) and an age-matched control group of 41 patients with no rejection (NR) were analyzed for sCD30. The transplant biopsies were immunostained for C4d. The median sCD30 level was significantly elevated in the group with VR (248 Units (U)/mL, range: 92-802) when compared with TIR (103 U/mL, range: 36-309, p<0.001) and NR (179 U/mL, range: 70-343, p<0.03). Moreover, patients with TIR had significantly lower sCD30 levels compared to NR. Based on C4d staining, a TH2 driven process, the median sCD30 levels were significantly raised in C4d+ patients compared with C4d- group (177 U/mL vs. 120 U/mL, p<0.05). sCD30 levels measured at time of transplantation correlate with the grade of rejection. High pre-transplant levels are associated with antibody-mediated rejection which carries a poorer prognosis. sCD30 could be another tool to assess immunological risk prior to transplantation and enable a patient centered approach to immunosuppression.
Department of Nephrology, Barts and the London NHS Trust, Whitechapel London E1 1BB, UK. rav.r@virgin.net
Ravindra
R
Rajakariar
Naina
N
Jivanji
Mira
M
Varagunam
Mohammad
M
Rafiq
Arun
A
Gupta
Michael
M
Sheaff
Paul
P
Sinnott
M M
MM
Yaqoob
D000328:Adult; D015935:Complement C4b / Q000378:metabolism; D005260:Female; D006084:Graft Rejection / Q000097:blood*; D006801:Humans; D017730:Ki-1 Antigen / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D010446:Peptide Fragments / Q000378:metabolism; D011237:Predictive Value of Tests; D011379:Prognosis
D017730:Ki-1 Antigen; D010446:Peptide Fragments; D015935:Complement C4b; C032261:complement C4d