Association of high post-transplant soluble CD30 serum levels with chronic allograft nephropathy.
The purpose of this study was to evaluate the association of post-transplant soluble CD30 (sCD30) levels, isolated or in combination with of anti-HLA class II antibodies and of serum creatinine levels, with kidney graft loss due to chronic allograft nephropathy (CAN), and type of lesions in graft biopsies for cause. The study comprised 511 first kidney graft recipients, transplanted at a single center, with a graft functioning for at least 2.8 years. A single blood sample was collected from each patient. sCD30 levels were determined by ELISA, and HLA antibodies by Luminex assay. The minimum follow-up after testing was 9.3 years. High sCD30 levels, set at sCD30 ≥ 34.15 ng/mL, the presence of HLA class II antibodies, and serum creatinine ≥ 1.9 mg/dL were independently associated with CAN-graft loss (P values <0.0001, 0.05, <0.0001, respectively), and the combined hazard ratio for CAN-graft loss was 20.2. Analyses of 166 biopsies for cause showed that high sCD30 levels and creatinine were independently associated with interstitial lesions. Post-transplant sCD30 serum levels, especially in conjunction with information regarding HLA class II antibodies and serum creatinine levels, provide valuable information regarding graft outcome and could be useful for the management of kidney transplant recipients.
Instituto de Imunogenética, AFIP, São Paulo, SP, Brazil; Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Patricia C
PC
Grenzi
Érika F
ÉF
Campos
Hélio
H
Tedesco-Silva
Claudia R
CR
Felipe
Marcello F
MF
Franco
Maria Fernanda
MF
Soares
José Osmar
JO
Medina-Pestana
Maria
M
Gerbase-Delima
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood* / Q000276:immunology; D000949:Histocompatibility Antigens Class II / Q000276:immunology / Q000378:metabolism; D006801:Humans; D007518:Isoantibodies / Q000097:blood* / Q000276:immunology; D017730:Ki-1 Antigen / Q000097:blood* / Q000276:immunology; D007674:Kidney Diseases / Q000097:blood* / Q000209:etiology / Q000276:immunology / Q000517:prevention & control; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000949:Histocompatibility Antigens Class II; D007518:Isoantibodies; D017730:Ki-1 Antigen; D003404:Creatinine
AUC; AZA; Ab; Alloantibodies; Antibody; Area under the curve; Arteriolar hyaline thickening; Azathioprine; CAN; CI; CSA; Chronic allograft nephropathy; Confidence interval; Cyclosporine; ELISA; Enzyme-linked immunosorbent assay; Estimated glomerular filtration rate; Glomerulopathy; HR; Hazard ratio; IF/TA; Immunologic monitoring; Interstitial fibrosis; Interstitial fibrosis and tubular atrophy; Kidney transplantation; MMF; Mesangial matrix expansion; Mycophenolate mofetil; PRED; Post-transplant monitoring; Prednisone; ROC; Receiver–operator characteristic; Sample mean fluorescence intensity; Soluble CD30; TAC; Tacrolimus; Tubular atrophy; Vascular fibrous intimal thickening; ah; cg; ci; ct; cv; eGFR; mm; sCD30; sMFI