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移植前可溶性CD30水平对急性排斥反应的影响有限,但会影响活体供肾移植中的移植肾功能。

Pretransplant soluble CD30 level has limited effect on acute rejection, but affects graft function in living donor kidney transplantation.

作者信息

Kim Myoung Soo, Kim Hae Jin, Kim Soon Il, Ahn Hyung Joon, Ju Man Ki, Kim Hyun Jung, Jeon Kyung Ock, Kim Yu Seun

机构信息

Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.

出版信息

Transplantation. 2006 Dec 27;82(12):1602-5. doi: 10.1097/01.tp.0000248779.17754.5e.

Abstract

BACKGROUND

Serum soluble CD30 (sCD30) levels might be a useful marker of immunologic status in pre transplant (Tx) recipients. We retrospectively correlated preTx sCD30 levels (high versus low) on postTx graft survival, incidence of acute rejection, and graft function using stored preTx serum.

METHODS

Of 254 recipients who underwent kidney Tx, 120 recipients were enrolled under the uniform criteria (living donor, age >25 years, viral hepatitis free, diabetes free).

RESULTS

The preTx sCD30 was not significantly associated with differences in graft survival rate during 47.5+/-11.4 months of follow-up (P = 0.5901). High sCD30 (> or =115 U/ml) was associated with a higher incidence of clinically or pathologically defined acute rejection than low sCD30, but the difference was not statistically significant (33.9% vs. 22.4%, P = 0.164). The response rate to antirejection therapy in patients with high sCD30 was inferior to those with low sCD30, but also was not statistically significant (33.3% vs. 7.7%, P = 0.087). However, mean serum creatinine levels in high sCD30 patients at one month, one year, and three years postTx were significantly different from those with low sCD30 (P < 0.05). In multiple regression analysis, acute rejection episodes, donor age, kidney weight/recipient body weight ratio, and preTx sCD30 levels were independent variables affecting the serum creatinine level three years postTx.

CONCLUSION

PreTx sCD30 level has a limited effect on the incidence of acute rejection and response to antirejection treatment, but inversely and independently affects serum creatinine level after living donor kidney transplantation.

摘要

背景

血清可溶性CD30(sCD30)水平可能是移植前(Tx)受者免疫状态的一个有用标志物。我们使用储存的移植前血清,回顾性地分析了移植前sCD30水平(高与低)与移植后移植物存活、急性排斥反应发生率及移植物功能之间的相关性。

方法

在254例接受肾移植的受者中,120例受者根据统一标准入选(活体供者,年龄>25岁,无病毒性肝炎,无糖尿病)。

结果

在47.5±11.4个月的随访期间,移植前sCD30与移植物存活率的差异无显著相关性(P = 0.5901)。与低sCD30相比,高sCD30(≥115 U/ml)与临床或病理定义的急性排斥反应发生率较高相关,但差异无统计学意义(33.9%对22.4%,P = 0.164)。高sCD30患者对抗排斥治疗的反应率低于低sCD30患者,但也无统计学意义(33.3%对7.7%,P = 0.087)。然而,移植后1个月、1年和3年时,高sCD30患者的平均血清肌酐水平与低sCD30患者有显著差异(P < 0.05)。在多元回归分析中,急性排斥反应发作次数、供者年龄、肾重量/受者体重比和移植前sCD30水平是影响移植后3年血清肌酐水平的独立变量。

结论

移植前sCD30水平对急性排斥反应发生率及对抗排斥治疗的反应影响有限,但在活体供肾移植后,它对血清肌酐水平有反向且独立的影响。

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