Pre-transplant risk evaluation of not only acute rejection and graft loss but pneumonia by soluble CD30 level in renal transplant recipients / 中华器官移植杂志

ABSTRACT

Objective To analyze the pre-transplant sera of renal graft recipients for soluble CD30 level and study the correlation between sCD30 level and acute rejection (AR),lung infection or renal graft loss.To investigate the feasibility of sCD30 level for pre-transplant risk evaluation in renal transplant recipients.Methods 586 renal graft recipients were enrolled into this study,who had complete 5-year follow-up data and sufficient pre-transplant sera for analysis.Pre-transplant sera were collected for detection of sCD30 level by ELISA and patients were divided into three groups according to sCD30 levelgroup L (sCD30＜120 U/ml),group I (sCD30 120-240U/ml) and group H (sCD30 ＞240 U/ml).Incidence of AR,lung infection,graft loss and postoperative 5-year patients and renal allograft survival rate were compared among three groups.Correlation analysis was also performed between pre-operative sCD30 level and postoperative dialysis time,AR,or lung infection.Results The average pre-transplantation sCD30 level was significantly higher than that of healthy individuals (P＜0.01 ).During the 5-year follow-up period,the incidence of AR in groups L,I and H was 17.4％ (45/259),29.2％ (77/264) and 42.9％ (27/63) respectively,and the lung infection rate was 20.8％,8.3％ and 15.9％ respectively.There was significant differences in AR incidence and lung infection rate among these three groups (P＜0.01).The pre-transplantation sCD30 level in patients with AR was (180.0± 89.1) U/ml,which was significantly higher than in those without AR (135.3 ± 72.7 U/ml,P＜0.01).The pre-transplantation sCD30 level in patients with lung infection was (123.2±75.5) U/ml,which was significantly lower than in those without lung infection (150.7 ± 79.6 U/mL,P＜0.01).The pre-transplantation sCD30 level had a positive relationship with AR (r =0.242,P＜0.01),but a negative correlation with lung infection (r=- 0.147,P＜0.01).In group H, five-year cumulative survival rate of recipients and renal grafts was 79.4％ and 69.8％ respectively,which was significantly lower than in group L (90.3％ and 87.3％),and group I (91.3％ and 87.6％) (P＜0.05,P＜0.01),but there was no significant difference between group L and group I (P＜0.01).Conclusion Pretransplant sCD30 level in renal transplant recipients is remarkably correlated with postoperative AR and lung infection,which can be considered as an independent predictor for postoperative AR,lung infection and the risk of graft function loss.