Pretransplant positivity for circulating thyroid antibodies and graft survival in patients undergoing kidney transplant.
BACKGROUND
Thyroid disturbances are common in kidney graft recipients and they may influence graft function. CXC chemokine ligand 10 plays a role in both autoimmune thyroiditis and graft rejection. Thyroid antibody (Ab) positivity has been regarded as a marker of imbalance of the immune system.


OBJECTIVE
To relate pretransplant positivity for antithyroperoxidase (TPO) Ab and antithyroglobulin (Tg) Ab with kidney graft outcome.


METHODS
Pretransplant thyroid antibodies were measured in 211 kidney graft recipients.


RESULTS
The 5-year death-censored graft survival rate was 91.5%. Pretransplant circulating Tg Ab and TPO Ab were detected in 12 (5.7%) and 13 (6.2%) patients, respectively. Lifetime analysis showed similar 5-year graft survival rates in patients negative or positive for Tg Ab and TPO Ab (91.5 vs. 91.7% for Tg Ab and 91.9 vs. 84.6% for TPO Ab). However, patients with pretransplant positivity for TPO Ab showed a significantly lower 5-year graft survival when early graft loss (12 months after transplant) was excluded (84.6 and 96.8% for TPO Ab+ and TPO Ab- patients, respectively; p < 0.05). Occurrence of acute rejection and chronic allograft nephropathy was unrelated to thyroid Ab positivity. Serum CXC chemokine ligand 10 levels were similar independent of Tg Ab and TPO Ab positivity.


CONCLUSIONS
Pretransplant positivity for TPO Ab may affect long-term graft survival in kidney graft recipients independent of occurrence of acute rejections and chronic allograft nephropathy.
Rotondi
Mario
M
Unit of Internal Medicine and Endocrinology Fondazione Salvatore Maugeri IRCCS, ISPESL Laboratory for Endocrine Disruptors, and Department of Endocrinology, University of Pavia, Pavia, Italy.
Leporati
Paola
P
Lodigiani
Sara
S
Netti
Giuseppe Stefano
GS
Precerutti
Sara
S
Magri
Flavia
F
Rosati
Alberto
A
Pradella
Fabio
F
Salvadori
Maurizio
M
Serio
Mario
M
Romagnani
Paola
P
Chiovato
Luca
L
D000208:Acute Disease; D000328:Adult; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D054357:Chemokine CXCL10 / Q000097:blood / Q000276:immunology; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D006084:Graft Rejection / Q000097:blood* / Q000276:immunology; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D013961:Thyroid Gland / Q000276:immunology*; D013997:Time Factors
D001323:Autoantibodies; C114753:CXCL10 protein, human; D054357:Chemokine CXCL10