Pre-transplant soluble CD30 level as a predictor of not only acute rejection and graft loss but pneumonia in renal transplant recipients.
Pre-transplant sera of 586 renal graft recipients were tested to investigate whether soluble CD30 (sCD30) is a useful predictor of some severe clinical episodes post-transplant. Correlation analysis showed sCD30 level was significantly correlated with acute rejection (AR) (r=0.242, P<0.001), graft loss (r=0.162, P<0.001), and pneumonia (r=-0.147, P<0.001). Higher sCD30 levels were observed in patients with AR than the others (180.0+/-89.1 vs. 135.3+/-72.7U/ml, P<0.001). And patients with pneumonia had significantly lower pre-transplant sCD30 level than the others (123.2+/-75.5 vs. 150.7+/-79.6U/ml, P=0.003). Based on statistical results, 120 and 240U/ml were selected as the optimal couple of cut-off value to divide patients into three groups: Group High (H), Group Intermedial (I) and Group Low (L). The lowest AR rate of 17.4% was observed in Group L (P<0.001). Significant difference of AR rate was also observed between Group I (29.2%) and H (42.9%) (P<0.001). There were much more patients suffering pneumonia in Group L (P=0.001). Significantly lower 5-year patient survival rate (79.4%) was observed in Group H (P=0.016). These data showed that elevated pre-transplant sCD30 level of renal allograft recipients may reflect an immune state detrimental for renal allograft survival. But sCD30 level lower than <120U/ml may be associated with a high risk of pneumonia. Pre-transplant sCD30 level is an independent predictor of acute rejection, lung infection, even graft survival. Suitable immunosuppression protocol should be selected according to pre-transplant sCD30 level in an attempt to promote patient and graft survival.
Wang
Dong
D
Organ Transplant Institute, Fuzhou General Hospital, Fuzhou 350025, China. wangdong1202@medmail.com.cn
Wu
Wei-Zhen
WZ
Chen
Jin-Hua
JH
Yang
Shun-Liang
SL
Wang
Qing-Hua
QH
Zeng
Zhang-Xin
ZX
Tan
Jian-Ming
JM
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D007165:Immunosuppression Therapy; D017730:Ki-1 Antigen / Q000097:blood*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D016019:Survival Analysis
D015415:Biomarkers; D017730:Ki-1 Antigen