Serial soluble CD30 measurements as a predictor of kidney graft outcome.
BACKGROUND
High levels of soluble CD30 (sCD30), a marker for T-helper 2-type cytokine-producing T cells, pre or post-renal transplantation serves as a useful predictor of acute rejection episodes. Over the course of 1-year, we evaluated the accuracy of serial sCD30 tests to predict acute rejection episodes versus other pathologies that affect graft outcomes.


METHODS
Fifty renal transplant recipients were randomly selected to examine sCD30 on days 0, 3, 5, 7, 14, and 21 followed by 1, 3, 6, and 12 months. The results were analyzed for development of an acute rejection episode, acute tubular necrosis (ATN), or other pathology as well as the graft outcome at 1 year.


RESULTS
Compared with pretransplantation sCD30, there was a significant reduction in the average sCD30 immediately posttransplantation from day 3 onward (P<.0001). Patients were divided into four groups: (1) uncomplicated courses (56%); (2) acute rejection episodes (18%); (3) ATN (16%); and (4) other diagnoses (10%). There was a significant reduction in sCD30 immediately posttransplantation for groups 1, 2, and 3 (P<.0001, .004, and .002 respectively) unlike group 4 (P=.387). Patients who developed an acute rejection episode after 1 month showed higher pretransplantation sCD30 values than these who displayed rejection before 1 month (P=.019). All groups experienced significant improvement in graft function over 1-year follow-up without any significant differences.


CONCLUSIONS
Though a significant drop of sCD30 posttransplantation was recorded, serial measurements of sCD30 did not show a difference among subjects who displayed acute rejection episodes, ATN, or other diagnoses.
Halim
M A
MA
Hamed Al-Essa-Organ Transplantation Centre, Ibn Sina Hospital, Safat, Kuwait. medhatmohamed2000@yahoo.com
Al-Otaibi
T
T
Al-Muzairai
I
I
Mansour
M
M
Tawab
K A
KA
Awadain
W H
WH
Balaha
M A
MA
Said
T
T
Nair
P
P
Nampoory
M R N
MR
D000208:Acute Disease; D000328:Adult; D015703:Antigens, CD / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000175:diagnosis; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017730:Ki-1 Antigen / Q000097:blood*; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D019520:Living Donors / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012086:Reoperation / Q000706:statistics & numerical data; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult
D015703:Antigens, CD; D007166:Immunosuppressive Agents; D017730:Ki-1 Antigen