title: Assessment of pretransplant inflammation in pediatric renal allograft recipients.
abstract: 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.
authors: Section of Pediatric Nephrology, University of California, Davis Medical Center, Sacramento, CA 95817, USA. lavjay.butani@ucdmc.ucdavis.edu
authors: Lavjay
authors: L
authors: Butani
authors: Jeremy
authors: J
authors: Johnson
authors: Christoph
authors: C
authors: Troppmann
authors: John
authors: J
authors: McVicar
authors: Richard V
authors: RV
authors: Perez
mesh_terms: 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
chemical_list: D018664:Interleukin-12; D019798:Neopterin; D002097:C-Reactive Protein