Chlamydia pneumoniae infection: an additional factor for chronic allograft rejection.
BACKGROUND
Chronic rejection (CHR) of organ allografts, one of the most significant problems in modern transplantation, is not fully understood. This study sought to evaluate the influence of selected parameters on late kidney transplant function.


METHODS
The studied group consisted of eighty-six patients who received allogeneic transplants between 1988 and 1999 for leukocyte Chlamydia pneumoniae-DNA, immunoglobulin (Ig)A/IgG anti-C pneumoniae, blood lipids, ischemic damage in the donor and during organ preservation, HLA mismatch, and acute rejection episodes.


RESULTS
Eighty-six patients were segregated as 26 patients (30%) with histologically proven chronic graft rejection (CHR[+]) and 59 patients (70%) without (CHR[-]). The presence of C pneumoniae-DNA in peripheral blood leukocytes was significantly more frequent in CHR(+) than CHR(-) group (46% vs 20%). Patients with leukocytes positive for C pneumoniae-DNA more frequently (50%) had CHR than patients negative for C pneumoniae-DNA (22%). CHR(+) patients showed significantly lower HDL levels (47 mg/dL vs 58 mg/dL) and higher triglyceride levels (193 mg/dL vs 148 mg/dL). To study the cumulative effect of differences between the CHR(+) and CHR(-) groups, we applied a multiple binary logistic regression analysis. An econometric model enabled us to calculate the probability of CHR for a given patient taking into account covariates chosen by means of stepwise selection: the presence of C pneumoniae-DNA in blood leukocytes, the use of continuous pulsatile perfusion in hypothermia, myocardial infarction occurrence, and triglyceride concentrations.


CONCLUSIONS
The presence of C pneumoniae-DNA in peripheral blood leukocytes increased the risk of CHR, which may be predicted by a multifactor analysis of chosen parameters.
Kwiatkowski
A
A
Department of General and Transplantation Surgery, Warsaw Medical University, ul. Nowogrodzka 59, 02-006 Warsaw, Poland.
Wszola
M
M
Nosek
R
R
Podsiadly
E
E
Meszaros
J
J
Ostrowski
K
K
Lisik
W
W
Michalak
G
G
Chmura
A
A
Kosieradzki
M
M
Danielewicz
R
R
Fesolowicz
S
S
Kasprzyk
T
T
Paczek
L
L
Durlik
M
M
Persson
K
K
Tylewska-Wierzbanowska
S
S
Rowinski
W
W
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D023521:Chlamydophila Infections / Q000150:complications*; D016993:Chlamydophila pneumoniae; D002908:Chronic Disease; D004269:DNA, Bacterial / Q000097:blood; D006084:Graft Rejection / Q000097:blood / Q000453:epidemiology* / Q000382:microbiology; D006650:Histocompatibility Testing; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D016030:Kidney Transplantation / Q000276:immunology / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D014280:Triglycerides / Q000097:blood
D000907:Antibodies, Bacterial; D004269:DNA, Bacterial; D007074:Immunoglobulin G; D014280:Triglycerides