HLA antibodies and soluble CD30 are associated with poor renal graft outcome: updated results of a single-center cross-sectional study.
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.
Langan
Leanne L
LL
Department of Clinical Immunology and Biochemical Genetics, PathWest, Royal Perth Hospital, Western Australia.
D'Orsogna
Lloyd
L
Park
Lawrence P
LP
Hughes
Tiffany L
TL
Irish
Ashley
A
Luxton
Grant
G
Witt
Campbell S
CS
Christiansen
Frank T
FT
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
D015703:Antigens, CD; D006680:HLA Antigens; D006681:HLA-D Antigens; D007518:Isoantibodies; D017730:Ki-1 Antigen