Pretransplant Positivity for Circulating Thyroid Antibodies and Graft Survival in Patients Undergoing Kidney Transplant

Abstract

Background: Thyroid disturbances are common in kidney graft recipients and they may influence graft function. CXC chemokine ligand 10 plays a role in both autoimmune thyroiditis and graft rejection. Thyroid antibody (Ab) positivity has been regarded as a marker of imbalance of the immune system. Aim: To relate pretransplant positivity for antithyroperoxidase (TPO) Ab and antithyroglobulin (Tg) Ab with kidney graft outcome. Methods: Pretransplant thyroid antibodies were measured in 211 kidney graft recipients. Results: The 5-year death-censored graft survival rate was 91.5%. Pretransplant circulating Tg Ab and TPO Ab were detected in 12 (5.7%) and 13 (6.2%) patients, respectively. Lifetime analysis showed similar 5-year graft survival rates in patients negative or positive for Tg Ab and TPO Ab (91.5 vs. 91.7% for Tg Ab and 91.9 vs. 84.6% for TPO Ab). However, patients with pretransplant positivity for TPO Ab showed a significantly lower 5-year graft survival when early graft loss (12 months after transplant) was excluded (84.6 and 96.8% for TPO Ab+ and TPO Ab– patients, respectively; p < 0.05). Occurrence of acute rejection and chronic allograft nephropathy was unrelated to thyroid Ab positivity. Serum CXC chemokine ligand10 levels were similar independent of Tg Ab and TPO Ab positivity. Conclusion: Pretransplant positivity for TPO Ab may affect long-term graft survival in kidney graft recipients independent of occurrence of acute rejections and chronic allograft nephropathy.