title: Elevated soluble cellular adhesion molecules are associated with increased mortality in a prospective cohort of renal transplant recipients.
abstract: BACKGROUND
  Increased plasma levels of cellular adhesion molecules (CAMs) have been shown to be predictors of all cause mortality in individuals with chronic renal failure 12 and patients with end-stage renal disease receiving haemodialysis 3. In renal transplant recipients the predictive value of CAMs has not been well characterised. The aim of this study was to assess the relationship between CAMs and all-cause mortality during prospective follow-up of a renal transplant cohort.
  
  
  METHODS
  A total of 378 renal transplant recipients were recruited between June 2000 and December 2002. Soluble vascular CAM-1 (VCAM) and soluble intercellular CAM-1 (ICAM) were measured at baseline and prospective follow-up data was collected at a median of 2441 days after enrolment.
  
  
  RESULTS
  In univariate survival analysis the renal transplant recipients with a VCAM or ICAM concentration in the lowest third were significantly more likely to have survived at follow-up (p < 0.001 and p = 0.009 respectively). In multivariate survival analysis VCAM and ICAM remained significant independent predictors of mortality following adjustment for traditional cardiovascular risk factors, hsCRP and estimated GFR (p = 0.030 and p = 0.037 respectively).
  
  
  CONCLUSIONS
  The results of this prospective study are the first to show that the CAMs, ICAM and particularly VCAM, are significant independent predictors of mortality in patients with a renal transplant.
authors: Department of Clinical Biochemistry, Royal Victoria Hospital, Belfast, Northern Ireland. grainnemconnolly@aol.co.uk
authors: Grainne M
authors: GM
authors: Connolly
authors: Ronan
authors: R
authors: Cunningham
authors: Peter T
authors: PT
authors: McNamee
authors: Ian S
authors: IS
authors: Young
authors: Alexander P
authors: AP
authors: Maxwell
references: J Intern Med. 2002 Oct;252(4):283-94
references: 12366601
references: Clin Chim Acta. 2002 Feb;316(1-2):25-31
references: 11750271
references: Am J Kidney Dis. 1996 Feb;27(2):239-43
references: 8659500
references: Expert Opin Biol Ther. 2003 Feb;3(1):85-95
references: 12718733
references: Circulation. 2001 Sep 18;104(12):1336-42
references: 11560847
references: Nephrol Dial Transplant. 2000 Oct;15(10):1624-30
references: 11007832
references: Transplantation. 1994 Oct 27;58(8):905-11
references: 7524208
references: Nephron. 1998 Aug;79(4):399-407
references: 9689154
references: Circ Res. 2001 Oct 26;89(9):763-71
references: 11679405
references: Circulation. 2002 Mar 5;105(9):1135-43
references: 11877368
references: Lancet. 2001 Sep 22;358(9286):971-6
references: 11583751
references: Transplantation. 1995 Jun 27;59(12):1695-9
references: 7541576
references: Nephrol Dial Transplant. 1997 Jun;12(6):1122-31
references: 9198039
references: Am J Kidney Dis. 1998 Nov;32(5 Suppl 3):S112-9
references: 9820470
references: Am J Nephrol. 2008;28(2):265-74
references: 17989499
references: Hypertension. 1997 Feb;29(2):683-9
references: 9040457
references: Nephrol Dial Transplant. 2006 Jun;21(6):1603-10
references: 16476720
references: Am J Med. 1999 Jul;107(1):85-97
references: 10403357
references: Semin Arthritis Rheum. 1996 Feb;25(4):215-33
references: 8834012
references: Ann Intern Med. 1999 Mar 16;130(6):461-70
references: 10075613
references: Arterioscler Thromb Vasc Biol. 1998 Nov;18(11):1765-70
references: 9812916
references: Nephrol Dial Transplant. 2001 Aug;16(8):1545-9
references: 11477152
references: Ann N Y Acad Sci. 1992 Dec 4;667:324-31
references: 1285023