Peritransplant Soluble CD30 as a Risk Factor for Slow Kidney Allograft Function, Early Acute Rejection, Worse Long-Term Allograft Function, and Patients' Survival.

Andriy V Trailin,Svitlana N Nesterenko,Tamara N Nykonenko,Tetyana I Ostapenko,Olexandr S Nykonenko

doi:10.1155/2017/9264904

Andriy V Trailin, Svitlana N Nesterenko + Show 3 more

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https://doi.org/10.1155/2017/9264904

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Abstract

Background We aimed to determine whether serum soluble CD30 (sCD30) could identify recipients at high risk for unfavorable early and late kidney transplant outcomes. Methods Serum sCD30 was measured on the day of kidney transplantation and on the 4th day posttransplant. We assessed the value of these measurements in predicting delayed graft function, slow graft function (SGF), acute rejection (AR), pyelonephritis, decline of allograft function after 6 months, and graft and patient survival during 5 years of follow-up in 45 recipients. Results We found the association between low pretransplant serum levels of sCD30 and SGF. The absence of significant decrease of sCD30 on the 4th day posttransplant was characteristic for SGF, early AR (the 8th day–6 months), late AR (>6 months), and early pyelonephritis (the 8th day–2 months). Lower pretransplant and posttransplant sCD30 predicted worse allograft function at 6 months and 2 years, respectively. Higher pretransplant sCD30 was associated with higher frequency of early AR, and worse patients' survival, but only in the recipients of deceased-donor graft. Pretransplant sCD30 also allowed to differentiate patients with early pyelonephritis and early AR. Conclusions Peritransplant sCD30 is useful in identifying patients at risk for unfavorable early and late transplant outcomes.

Highlights

Kidney transplantation is the optimal long-term treatment for most patients with end-stage chronic kidney disease [1]
Since the use of anti-CD25 antibodies led to significant decrease of soluble CD30 (sCD30) after transplantation, we suggest that patients with high pretransplant sCD30 can profit from the use of anti-CD25 antibodies or other intense immunosuppressive therapy directed on T cells, which was considered earlier by other authors [9, 15]
The results of the present study demonstrate the association between low and high pretransplant and posttransplant serum sCD30 and unfavorable short- and long-term outcomes after kidney transplantation

Summary

Introduction

Kidney transplantation is the optimal long-term treatment for most patients with end-stage chronic kidney disease [1]. Death with functioning graft and chronic renal allograft dysfunction are the major obstacles to improve outcomes after kidney transplantation [1]. The relationship between pretransplant sCD30 and acute tubular necrosis (ATN) or delayed graft function (DGF) has been investigated in several studies. We aimed to determine whether serum soluble CD30 (sCD30) could identify recipients at high risk for unfavorable early and late kidney transplant outcomes. We assessed the value of these measurements in predicting delayed graft function, slow graft function (SGF), acute rejection (AR), pyelonephritis, decline of allograft function after 6 months, and graft and patient survival during 5 years of follow-up in 45 recipients. Peritransplant sCD30 is useful in identifying patients at risk for unfavorable early and late transplant outcomes

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