title: Anti-vimentin Antibodies Present at the Time of Transplantation May Predict Early Development of Interstitial Fibrosis/Tubular Atrophy.
abstract: BACKGROUND
  Anti-vimentin (a cytoskeletal protein) autoantibodies in renal transplant recipients have been correlated with interstitial fibrosis/tubular atrophy (IFTA). In this study, we examine the association between pretransplantation anti-vimentin antibodies and the subsequent development of IFTA.
  
  
  METHODS
  Sera obtained before renal transplantation from 97 transplant recipients were analyzed for the presence of anti-vimentin antibodies via Luminex assays to determine the concentration of anti-vimentin antibodies. Results were correlated with findings of IFTA on biopsy as well as graft function and patient and graft survival.
  
  
  RESULTS
  In our patient population, 56 of 97 patients were diagnosed by biopsy with IFTA 2.9 (±2.1) years after renal transplantation. Patients with IFTA on biopsy had higher mean concentration of anti-vimentin antibodies when compared to patients without IFTA (32.2 μg/mL [3.97-269.12 μg/mL] vs 14.57 μg/mL [4.71-87.81 μg/mL]). The risk of developing IFTA with a concentration of anti-vimentin antibody >15 μg/mL before transplantation was 1.96 (95% CI = 1.38-2.79, P = .011). Patients with elevated anti-vimentin antibody concentrations (>15 μg/mL) at the time of transplantation also had a higher risk of developing IFTA (81.4% vs 41.2%; P < .05). In addition, graft function was worse at 1, 3, and 5 years posttransplantation in patients with elevated concentrations of pretransplantation anti-vimentin antibody. Although there were more graft losses in the IFTA groups (49.12% vs 25.64%, P = .021) and the IFTA patients loss their grafts earlier (4.3 years vs 3.6 years), there was no statistical difference in graft loss rates.
  
  
  CONCLUSIONS
  Pretransplantation anti-vimentin antibody concentrations >15 μg/mL may be a risk factor for IFTA.
authors: Division of Surgery, Section of Transplantation, Albany Medical Center, Albany, New York. Electronic address: lopezsr@mail.amc.edu.
authors: R I
authors: RI
authors: Lopez-Soler
authors: Department of Biochemistry, Rush University Medical Center, Chicago, Illinois; Department of Pathology, Rush University Medical Center, Chicago, Illinois.
authors: J A
authors: JA
authors: Borgia
authors: Department of Pathology, Rush University Medical Center, Chicago, Illinois.
authors: S
authors: S
authors: Kanangat
authors: Department of Pathology, Rush University Medical Center, Chicago, Illinois.
authors: C L
authors: CL
authors: Fhied
authors: Division of Surgery, Section of Transplantation, Albany Medical Center, Albany, New York.
authors: D J
authors: DJ
authors: Conti
authors: Transplant Immunology Laboratory, Albany Medical College, Albany, New York.
authors: D
authors: D
authors: Constantino
authors: Division of Surgery, Section of Transplantation, Albany Medical Center, Albany, New York.
authors: A
authors: A
authors: Ata
authors: Division of Surgery, Section of Transplantation, Albany Medical Center, Albany, New York.
authors: R
authors: R
authors: Chan
authors: Center For Cardiovascular Sciences, Albany Medical College, Albany, New York.
authors: Z
authors: Z
authors: Wang
mesh_terms: D000328:Adult; D001284:Atrophy; D001323:Autoantibodies / Q000097:blood*; D001706:Biopsy; D005260:Female; D005355:Fibrosis; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival / Q000276:immunology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D007684:Kidney Tubules / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014746:Vimentin / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D014746:Vimentin