Pretransplantation soluble CD30 level as a predictor of acute rejection in kidney transplantation:  a meta-analysis.
BACKGROUND
The question of whether high pretransplantation soluble CD30 (sCD30) level can be a predictor of kidney transplant acute rejection (AR) is under debate. Herein, we performed a meta-analysis on the predictive efficacy of sCD30 for AR in renal transplantation.


METHODS
PubMed (1966-2012), EMBASE (1988-2012), and Web of Science (1986-2012) databases were searched for studies concerning the predictive efficacy of sCD30 for AR after kidney transplantation. After a careful review of eligible studies, sensitivity, specificity, and other measures of the accuracy of sCD30 were pooled. A summary receiver operating characteristic curve was used to represent the overall test performance.


RESULTS
Twelve studies enrolling 2507 patients met the inclusion criteria. The pooled estimates for pretransplantation sCD30 in prediction of allograft rejection risk were poor, with a sensitivity of 0.70 (95% confidence interval (CI), 0.66-0.74), a specificity of 0.48 (95% CI, 0.46-0.50), a positive likelihood ratio of 1.35 (95% CI, 1.20-1.53), a negative likelihood ratio of 0.68 (95% CI, 0.55-0.84), and a diagnostic odds ratio of 2.07 (95% CI, 1.54-2.80). The area under curve of the summary receiver operating characteristic curve was 0.60, indicating poor overall accuracy of the serum sCD30 level in the prediction of patients at risk for AR.


CONCLUSIONS
The results of the meta-analysis show that the accuracy of pretransplantation sCD30 for predicting posttransplantation AR was poor. Prospective studies are needed to clarify the usefulness of this test for identifying risks of AR in transplant recipients.
Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Yile
Y
Chen
Qiang
Q
Tai
Shaodong
S
Hong
Yuan
Y
Kong
Yushu
Y
Shang
Wenhua
W
Liang
Zhiyong
Z
Guo
Xiaoshun
X
He
D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000097:blood / Q000453:epidemiology / Q000276:immunology*; D006801:Humans; D017730:Ki-1 Antigen / Q000097:blood*; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D057234:Preoperative Period; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity
D015415:Biomarkers; D017730:Ki-1 Antigen