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Association of high post-transplant soluble CD30 serum levels with chronic allograft nephropathy
Patricia C Grenzi1, Érika F Campos, Hélio Tedesco-Silva
1Instituto de Imunogenética, AFIP, São Paulo, SP, Brazil; Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Insights
High post-transplant soluble CD30 (sCD30) levels, combined with HLA class II antibodies and creatinine, significantly predict kidney transplant loss from chronic allograft nephropathy (CAN). These markers aid in managing transplant recipients.
Area of Science:
- Nephrology
- Immunology
- Transplantation Medicine
Background:
- Chronic allograft nephropathy (CAN) is a major cause of kidney transplant failure.
- Predictive biomarkers for CAN are crucial for optimizing patient management and improving graft survival.
Purpose of the Study:
- To assess the association of post-transplant soluble CD30 (sCD30) levels, anti-HLA class II antibodies, and serum creatinine with kidney graft loss due to CAN.
- To investigate the relationship between these markers and specific lesions identified in kidney graft biopsies.
Main Methods:
- A cohort study of 511 first kidney transplant recipients with a minimum follow-up of 9.3 years.
- Quantification of serum sCD30 by ELISA and anti-HLA class II antibodies by Luminex assay from single blood samples.
- Analysis of graft biopsies for cause in 166 patients.
Main Results:
- High sCD30 levels (≥ 34.15 ng/mL), presence of HLA class II antibodies, and elevated serum creatinine (≥ 1.9 mg/dL) were independently associated with CAN-related graft loss.
- The combined hazard ratio for CAN-graft loss was 20.2.
- High sCD30 and creatinine levels were independently linked to interstitial lesions in graft biopsies.
Conclusions:
- Post-transplant sCD30 levels, particularly when considered with HLA class II antibodies and creatinine, are valuable predictors of kidney graft outcome.
- These biomarkers can assist in the clinical management of kidney transplant recipients to mitigate CAN progression.
Abstract:
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.
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