Instituto de Imunogenética, AFIP, São Paulo, SP, Brazil; Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Transpl Immunol. 2013 Dec;29(1-4):34-8. doi: 10.1016/j.trim.2013.07.003. Epub 2013 Aug 6.
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.
本研究旨在评估移植后可溶性 CD30(sCD30)水平、单独或联合抗 HLA Ⅱ类抗体和血清肌酐水平与慢性移植肾肾病(CAN)导致的移植物丢失的相关性,并分析移植后活检的病变类型。该研究纳入了 511 例在单一中心接受首次肾移植的患者,这些患者的移植物功能至少持续了 2.8 年。每位患者采集了一份血样。采用 ELISA 法测定 sCD30 水平,采用 Luminex 法测定 HLA 抗体。检测后的最低随访时间为 9.3 年。高 sCD30 水平(sCD30≥34.15ng/mL)、存在 HLA Ⅱ类抗体和血清肌酐≥1.9mg/dL 与 CAN 移植物丢失独立相关(P 值分别<0.0001、0.05、<0.0001),CAN 移植物丢失的联合危险比为 20.2。对 166 例病因活检的分析表明,高 sCD30 水平和肌酐与间质病变独立相关。移植后 sCD30 血清水平,特别是与 HLA Ⅱ类抗体和血清肌酐水平相结合的信息,可提供有关移植物结局的有价值信息,可能有助于管理肾移植受者。