Early post-transplant immune monitoring can predict long-term kidney graft survival: soluble CD30 levels, anti-HLA antibodies and IgA-anti-Fab autoantibodies.
This study aimed to investigate the predictive power of anti-HLA antibodies, sCD30 levels and IgA-anti-Fab autoantibody before and early after transplantation in relation to long-term kidney allograft survival. Pre- and post-transplant sera samples of 59 living-unrelated donor kidney recipients were tested for above risk factors by enzyme-linked immunoabsorbent assay. 15 out of 59 cases experienced rejection episodes (failure group). Pre- and post-transplant high sCD30 levels were significantly associated with graft failure (P=0.02 and P=0.004) and decreased 4 year graft survival (P = 0.009 and P = 0.001). Higher frequency of post-transplant HLA class-II antibody in the absence of class-I antibody was observed in failure group (P=0.007). Patients with post-transplant HLA class-I and class-II antibodies either alone or in combination showed significant lower 4 year graft survival. Recipients with high sCD30 levels in the presence of HLA class-I or class-II antibodies within 2 weeks post-transplant had poor graft survival (P = 0.004 and P = 0.002, respectively). High levels of post-transplant IgA-anti-Fab antibody was more frequent in functioning-graft patients (P = 0.00001), correlated with decreased serum creatinine levels (P = 0.01) and associated with improved graft survival (P = 0.008). Our findings indicate the deleterious effect of early post-transplant HLA antibodies and increased sCD30 levels dependently and protective effect of IgA-anti-Fab antibodies on long-term renal graft outcomes.
Department of Urology, Medical School, Hamadan University of Medical Sciences, Hamadan, Iran.
Mohammad Ali
MA
Amirzargar
Molecular Immunology Research Center, Medical School, Tehran University of Medical Sciences, Tehran, Iran.
Aliakbar
A
Amirzargar
Urology Research Center, Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abbas
A
Basiri
Immunology Department, Medical School, Hamadan University of Medical Sciences, Hamadan, Iran.
Mehrdad
M
Hajilooi
Research Center for Health Science, Department of Biostatistics and Epidemiology, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Ghodratollah
G
Roshanaei
Department of Urology, Medical School, Hamadan University of Medical Sciences, Hamadan, Iran.
Gholamreza
G
Rajabi
Department of Urology, Medical School, Hamadan University of Medical Sciences, Hamadan, Iran.
Sina
S
Mohammadiazar
Immunology Department, Medical School, Hamadan University of Medical Sciences, Hamadan, Iran. Electronic address: gh.solgi@umsha.ac.ir.
Ghasem
G
Solgi
D000328:Adult; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000276:immunology; D006085:Graft Survival / Q000276:immunology*; D006649:Histocompatibility Antigens / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood / Q000276:immunology; D007140:Immunoglobulin Fab Fragments / Q000276:immunology; D017730:Ki-1 Antigen / Q000097:blood / Q000276:immunology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015166:Monitoring, Immunologic
D001323:Autoantibodies; D006649:Histocompatibility Antigens; D007070:Immunoglobulin A; D007140:Immunoglobulin Fab Fragments; D017730:Ki-1 Antigen