Pre-transplant and post-transplant soluble CD30 for prediction and diagnosis of acute kidney allograft rejection |
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Authors: | Mohsen Nafar Farhat Farrokhi Mohammad Vaezi Amir-Ebrahim Entezari Fatemeh Pour-Reza-Gholi Ahmad Firoozan Behzad Eniollahi |
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Affiliation: | (1) Urology and Nephrology Research Center and Shaheed Labbafinejad Medical Center, Shaheed Beheshti Medical University, No 44, 9th Boustan, Pasdaran Avenue, Tehran, Iran;(2) Urology and Nephrology Research Center, Shaheed Beheshti Medical University, Tehran, Iran;(3) Shaheed Beheshti Medical University, Tehran, Iran;(4) Baghiatollah University of Health and Medical Services, Tehran, Iran |
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Abstract: | Background Serum levels of soluble CD30 (sCD30) have been considered as a predictor of acute kidney allograft rejection. We have evaluated the pre-transplant and post-transplant levels of sCD30 with the aim of determining its value in predicting and diagnosing kidney rejection. Methods We measured sCD30 serum levels before kidney transplantation, 5 days post-operatively, and at creatinine elevation episodes. The predictive value of sCD30 for diagnosing acute rejection (AR) within the first 6 post-operative months was assessed in 203 kidney recipients from living donors. Results Pre-transplant and post-operative levels of serum sCD30 were 58.10 ± 52.55 and 51.55 ± 49.65 U/ml, respectively (P = 0.12). Twenty-three patients experienced biopsy-proven acute rejection, and 28 had acute allograft dysfunction due to non-immunologic diseases. The pre-transplant sCD30 level was not different between patients with and without AR. However, post-transplant sCD30 was higher in the AR group. The median serum level of post-transplant sCD30 was 52 U/ml in the AR group and 26.3 U/ml in a control group (P < 0.001). The relative changes of sCD30 on day 5 were higher in patients with AR (P = 0.003). Based on post-transplant sCD30 levels, we were able to differentiate between kidney recipients who experienced an AR within 6 months post-surgery and those without an AR (cutoff value 41 U/ml; sensitivity 70%; specificity 71.7%). The level of sCD30 during periods of elevated serum creatinine was not independently associated with the diagnosis of AR. Conclusion Post-transplant sCD30 levels and their relative changes are higher in patients experiencing AR. We propose further studies on the post-transplant trend of this marker for the prediction of AR. |
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Keywords: | Acute rejection Diagnosis Graft survival Kidney transplantation Soluble CD30 |
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