title: HLA antibodies and soluble CD30 are associated with poor renal graft outcome: updated results of a single-center cross-sectional study.
abstract: In a previous study, we have shown that HLA class II antibodies and a high soluble CD30 (sCD30) measured at least 1 year post-transplant predict subsequent graft failure. We have now updated the results of this same cohort of 208 patients 15 months later. HLA-specific antibodies (class I and class II) were detected by ELISA LAT-M and Luminex LabScreen assays. Data on graft outcome was collected with a median follow-up of 4.7 years. By Kaplan-Meier analysis, class II antibody was again associated with a poorer outcome, with an estimated 6-year graft survival of 67% and 71% when detected by ELISA and Luminex, respectively, compared with 92% for those without class II antibody (p < or = 0.0001). A soluble CD30 level of > or = 100 U/ml was also associated with a poorer estimated 6-year graft survival (p = 0.02). HLA antibodies and high sCD30 (> or = 100 U/ml) had an additive effect such that those with both high sCD30 and class II antibodies had a hazard ratio for subsequent graft failure of 18.1 (p = 0.0008) and 8.6 (p = 0.007) when detected by ELISA and Luminex, respectively. These data show that detection of HLA class II antibodies and serum sCD30 measured at least 1 year post-transplant continues to predict a subsequent outcome up to 6 years after the initial measurement; they also show that such measures provide important information that may allow for modification of ongoing therapy.
authors: Department of Clinical Immunology and Biochemical Genetics, PathWest, Royal Perth Hospital, Western Australia.
authors: Leanne L
authors: LL
authors: Langan
authors: Lloyd
authors: L
authors: D'Orsogna
authors: Lawrence P
authors: LP
authors: Park
authors: Tiffany L
authors: TL
authors: Hughes
authors: Ashley
authors: A
authors: Irish
authors: Grant
authors: G
authors: Luxton
authors: Campbell S
authors: CS
authors: Witt
authors: Frank T
authors: FT
authors: Christiansen
mesh_terms: D015703:Antigens, CD / Q000097:blood; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D006680:HLA Antigens / Q000276:immunology*; D006681:HLA-D Antigens / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D017730:Ki-1 Antigen / Q000097:blood*; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality; D016019:Survival Analysis; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D015703:Antigens, CD; D006680:HLA Antigens; D006681:HLA-D Antigens; D007518:Isoantibodies; D017730:Ki-1 Antigen