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Published on: October 31, 2012
Serum HLA-G Levels in Kidney Transplant Recipients and Association With Clinical Outcomes: A Single-Center
Silvia Marçal Botelho1, Geovana Maria Nunes Arantes Chaves2, Isabela Jubé Wastowski3
1Universidade Federal de Goiás - Faculdade de Medicina, Departamento de Clínica Médica, Goiânia, Goiás, Brazil; Santa Casa de Goiânia - Kidney Transplant Unit, Goiânia, Goiás, Brazil; Pontifícia Universidade Católica de Goiás - Escola de Ciências Médicas e da Vida, School of Medicine, Nephrology Discipline, Goiânia, Goiás, Brazil.
Background:
HLA-G is a non-classical HLA class I molecule with immunomodulatory properties and has been proposed as a biomarker of immune tolerance in kidney transplantation. However, the clinical meaning of circulating HLA-G remains controversial.
Methods:
We conducted a cross-sectional, single-center study including kidney transplant recipients with available clinical data and serum samples. Soluble HLA-G levels were quantified by enzyme-linked immunosorbent assay. We tested associations between HLA-G levels and immunosuppressive regimen, acute rejection episodes, cytomegalovirus (CMV) infection, and early post-transplant need for hemodialysis. Statistical significance was defined as P < .05.
Results:
A total of 114 kidney transplant recipients were analyzed. Use of a regimen including corticosteroids, a calcineurin inhibitor, and azathioprine was associated with lower HLA-G levels (P < .001). Lower HLA-G levels were also associated with acute rejection (P < .001) and CMV infection (P = .006). In contrast, recipients requiring 6-10 hemodialysis sessions in the early post-transplant period showed higher HLA-G levels (P = .02).
Conclusions:
Serum HLA-G levels were significantly associated with clinically relevant outcomes after kidney transplantation. Lower HLA-G levels were linked to acute rejection and CMV infection, whereas higher HLA-G levels were observed among recipients requiring more hemodialysis early after transplantation. These findings support further evaluation of HLA-G as a prognostic biomarker.
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