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Infectious complications after simultaneous pancreas-kidney transplantation: a role for the lectin pathway of

Jeffrey J W Verschuren1, Anja Roos, Alexander F M Schaapherder

  • 1Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands.

Transplantation
|January 15, 2008
PubMed
Abstract

Insights

High mannose-binding lectin (MBL) levels protect against urinary tract infections and urosepsis in simultaneous pancreas-kidney transplant (SPKT) recipients. Low MBL levels increase the risk of these infectious complications post-SPKT.

Area of Science:

  • Immunology
  • Transplantation Medicine
  • Infectious Diseases

Background:

  • Mannose-binding lectin (MBL) is crucial for the lectin pathway of complement activation.
  • MBL serum levels are influenced by MBL gene polymorphisms.
  • The role of MBL deficiency in post-transplant infections is unclear.

Purpose of the Study:

  • To investigate the association between MBL deficiency and infectious complications after simultaneous pancreas-kidney transplantation (SPKT).

Main Methods:

  • Retrospective analysis of infectious complications in 152 SPKT patients.
  • Pretransplant serum MBL levels were measured using enzyme-linked immunosorbent assay (ELISA).

Main Results:

  • Increased MBL levels correlated with reduced odds of urinary tract infections (OR 0.83, P=0.045) and urosepsis (OR 0.68, P=0.029).
  • Urosepsis was significantly more frequent in patients with low MBL (<400 ng/mL) compared to those with higher levels (22.7% vs. 8.3%, P=0.015).
  • MBL levels did not significantly impact wound infections or cytomegalovirus disease.

Conclusions:

  • High serum MBL levels are associated with protection against urinary tract infections and urosepsis post-SPKT.
  • These findings highlight the importance of the lectin pathway in antimicrobial defense for transplant recipients.
  • MBL deficiency may represent a risk factor for specific infections after SPKT.

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