Soluble CD30 concentrations in ESRD patients with and without panel reactive HLA antibodies.
BACKGROUND
In this retrospective study we compared accuracy of panel reactive antibodies (PRA) with serum soluble CD30 (sCD30) contents in predicting acute rejection crisis post-renal transplant.


METHODS
Pre-transplant sera from 115 patients were evaluated for their PRA and sCD30 concentrations. All patients received calcineurin inhibitor-based immunosuppressive therapy. Objective measurements for rejection were biopsy-proven acute rejection (AR) episodes within first six months of the transplant. Post-transplant sera of patients with AR were tested for the presence of donor-specific HLA antibodies (DSA).


RESULTS
Overall AR rate was 16% (18/115). Patients positive for PRA and sCD30 tests were at significantly higher risk for AVR compared with those patients negative for both the tests (36% vs. 5%, p=0.01). Among negative PRA patients risk for AR was significantly elevated if they were also tested positive for sCD30 concentrations (21% vs. 5%, p=0.04). Of the 18 patients with AR, 14 were positive for sCD30, and 13 of them (93%) developed DSA post-transplant (p=0.001).


CONCLUSIONS
These data showed that patients positive for sCD30 contents are at high risk for the development of DSA and AR post-transplant regardless of their pre-transplant PRA.
Vaidya
Smita
S
Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555-0178, USA. svaidya@utmb.edu
Partlow
David
D
Barnes
Titus
T
Thomas
Phillip
P
Gugliuzza
Kristin
K
D015703:Antigens, CD / Q000097:blood; D001402:B-Lymphocytes / Q000276:immunology; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D017730:Ki-1 Antigen / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000276:immunology*; D016030:Kidney Transplantation / Q000276:immunology*; D012086:Reoperation; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000276:immunology; D016896:Treatment Outcome
D015703:Antigens, CD; D006680:HLA Antigens; D007518:Isoantibodies; D017730:Ki-1 Antigen