Evaluation of hepatocyte growth factor as a sensitive marker for early detection of acute renal allograft rejection.
BACKGROUND
It has been shown that hepatocyte growth factor (HGF), besides its well-established hepatotrophic effect in liver regeneration, is involved in the regeneration of the kidney after injury. In the present study we investigated whether HGF can serve as a marker for detection of acute rejection in the early posttransplantation period.


METHODS
HGF levels were determined in pre- and posttransplant sera (up to day 21) of 26 recipients with biopsy-proven acute rejection, 30 recipients with acute tubular necrosis (ATN), and 32 recipients without posttransplant complications.


RESULTS
Although no association was found between pretransplant HGF and death-censored functional graft survival, receiver operating characteristic (ROC) curves demonstrated that HGF measured during the entire posttransplant study period, and especially on days 3 to 5, was a good marker for differentiating recipients who subsequently developed acute rejection from recipients with an uncomplicated course (P<0.0001, specificity 87%, sensitivity 84%). HGF measured from day 3 until day 21 posttransplantation, and especially on days 7 to 9, was also a sensitive marker for differentiating recipients with ATN from recipients with an uncomplicated course (P<0.0001). If considered in combination with sCD30, the diagnostic value of HGF was further improved. While 73% of samples from patients with impending rejection were positive for both HGF and sCD30, 94% of samples from nonrejecting patients were double-negative and none of the samples from this group fell into the double-positive category (P<0.0001).


CONCLUSIONS
Our data suggest that HGF measured during the early posttransplant period might be a useful parameter for early detection of acute renal allograft rejection.
Mahmoud
Khaled
K
Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany.
Opelz
Gerhard
G
Pelzl
Steffen
S
Daniel
Volker
V
Sommerer
Claudia
C
Zeier
Martin
M
Schmidt
Jan
J
Schönemann
Constanze
C
Schnülle
Peter
P
Süsal
Caner
C
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D005260:Female; D006084:Graft Rejection / Q000097:blood* / Q000175:diagnosis*; D006262:Health; D017228:Hepatocyte Growth Factor / Q000097:blood*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous / Q000276:immunology / Q000473:pathology
D015415:Biomarkers; D017228:Hepatocyte Growth Factor