title: Soluble CD30 and ELISA-detected human leukocyte antigen antibodies for the prediction of acute rejection in pediatric renal transplant recipients.
abstract: Biomarker-based post-transplant immune monitoring for the prediction of impending graft rejection requires validation in specific patient populations. Serum of 28 pediatric renal transplant recipients within the framework of a well-controlled prospective randomized trial was analyzed pre- and post-transplant for soluble CD30 (sCD30), a biomarker reflecting mainly T-cell reactivity, and anti-human leukocyte antigen (anti-HLA) antibody reactivity, a biomarker for B-cell activation. A sCD30 concentration ≥40.3 U/ml on day 14 was able to discriminate between patients with or without biopsy-proven acute rejection (BPAR) with a sensitivity of 100% and a specificity of 76%. Six of seven patients (86%) with BPAR showed a sCD30 above this cut-off, whereas only 3/21 patients (14%) without BPAR had a sCD30 above this cut-off (P = 0.004). For pre- and post-transplant anti-HLA class II reactivities by enzyme-linked immunosorbent assay, a cut-off value of 140 optical density was able to discriminate rejecters from nonrejecters with a sensitivity of 86% or 71% and a specificity of 81% or 90%, respectively. Withdrawal of steroids was associated with a approximately twofold higher serum sCD30 compared to controls, but did not affect anti-HLA reactivities. An increased post-transplant sCD30 serum concentration and positive pre- and post-transplant anti-HLA class II reactivities are informative biomarkers for impending BPAR in pediatric renal transplant recipients. (TWIST, Clinical Trial No: FG-506-02-43).
authors.affiliation: Department of Pediatrics I, University Children's Hospital, D-69120 Heidelberg, Germany.
authors.forename: Heiko
authors.initials: H
authors.lastname: Billing
authors.forename: Anja
authors.initials: A
authors.lastname: Sander
authors.forename: Caner
authors.initials: C
authors.lastname: Süsal
authors.forename: Jörg
authors.initials: J
authors.lastname: Ovens
authors.forename: Reinhard
authors.initials: R
authors.lastname: Feneberg
authors.forename: Britta
authors.initials: B
authors.lastname: Höcker
authors.forename: Karel
authors.initials: K
authors.lastname: Vondrak
authors.forename: Ryszard
authors.initials: R
authors.lastname: Grenda
authors.forename: Stybjorn
authors.initials: S
authors.lastname: Friman
authors.forename: David V
authors.initials: DV
authors.lastname: Milford
authors.forename: Mihai
authors.initials: M
authors.lastname: Lucan
authors.forename: Gerhard
authors.initials: G
authors.lastname: Opelz
authors.forename: Burkhard
authors.initials: B
authors.lastname: Tönshoff
mesh_terms: D000367:Age Factors; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D016001:Confidence Intervals; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D017730:Ki-1 Antigen / Q000276:immunology* / Q000378:metabolism; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000379:methods; D016015:Logistic Models; D008297:Male; D010372:Pediatrics; D011237:Predictive Value of Tests; D012372:ROC Curve; D012016:Reference Values; D012995:Solubility; D016019:Survival Analysis; D013997:Time Factors; D014181:Transplantation Immunology / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006680:HLA Antigens; D007166:Immunosuppressive Agents; D017730:Ki-1 Antigen