Assessment of pretransplant inflammation in pediatric renal allograft recipients.
Pretransplant (Tx) inflammation is linked to adverse outcomes in adult Tx recipients but no such data exist for children. Our study evaluated the predictive value of three pre-Tx inflammatory markers: serum C-reactive protein (CRP), Neopterin (Neo) and interleukin (IL) 12, in determining outcome. Pre-Tx serum on 51 children (mean age 11 years) transplanted between 1985 and 2000 was analyzed. Data on other variables were abstracted from patient records. Primary end-points were graft survival and acute rejection (AR). Kaplan-Meier and log-rank statistics compared endpoints in patients at different quartiles for each marker. Cox regression analysis was used to determine the independent effect of the markers on the end-points. The mean CRP, Neo, and IL-12 were 1.3 mg/l, 1.78 ng/ml, and 123 pg/ml, respectively. The mean CRP, Neo, and IL-12 were not different between the patients with and without AR or graft loss (P > 0.4 for all). Neither rejection-free survival nor graft survival was affected by CRP, Neo, or IL-12 quartiles. Cox-regression analysis demonstrated no predictive value of any marker on outcome. Unlike adults, a single pre-Tx determination of inflammatory markers was not predictive of AR or graft loss in children, indicating that the pathogenesis of AR may be different in children.
Butani
Lavjay
L
Section of Pediatric Nephrology, University of California, Davis Medical Center, Sacramento, CA 95817, USA. lavjay.butani@ucdmc.ucdavis.edu
Johnson
Jeremy
J
Troppmann
Christoph
C
McVicar
John
J
Perez
Richard V
RV
D000293:Adolescent; D002097:C-Reactive Protein / Q000032:analysis*; D002648:Child; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007249:Inflammation / Q000150:complications; D018664:Interleukin-12 / Q000097:blood*; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D015999:Multivariate Analysis; D019798:Neopterin / Q000097:blood*; D011237:Predictive Value of Tests; D014184:Transplantation, Homologous
D018664:Interleukin-12; D019798:Neopterin; D002097:C-Reactive Protein