Increased Levels of sCD30 Have No Impact on the Incidence of Early ABMR and Long-Term Outcome in Intermediate-Risk Renal Transplant Patients With Preformed DSA
Drasch T, Bach C, Luber M, Spriewald B, Utpatel K, Büttner-Herold M, Banas B, Zecher D (2021)
Publication Type: Journal article
Publication year: 2021
Journal
Book Volume: 8
Article Number: 778864
Abstract
Background: It is still incompletely understood why some patients with preformed donor-specific anti-HLA antibodies (DSA) have reduced kidney allograft survival secondary to antibody-mediated rejection (ABMR), whereas many DSA-positive patients have favorable long-term outcomes. Elevated levels of soluble CD30 (sCD30) have emerged as a promising biomarker indicating deleterious T-cell help in conjunction with DSA in immunologically high-risk patients. We hypothesized that this would also be true in intermediate-risk patients. Methods: We retrospectively analyzed pre-transplant sera from 287 CDC-crossmatch negative patients treated with basiliximab induction and tacrolimus-based maintenance therapy for the presence of DSA and sCD30. The incidence of ABMR according to the Banff 2019 classification and death-censored allograft survival were determined. Results: During a median follow-up of 7.4 years, allograft survival was significantly lower in DSA-positive as compared to DSA-negative patients (p < 0.001). In DSA-positive patients, most pronounced in those with strong DSA (MFI > 5,000), increased levels of sCD30 were associated with accelerated graft loss compared to patients with low sCD30 (3-year allograft survival 75 vs. 95%). Long-term survival, however, was comparable in DSA-positive patients irrespective of sCD30 status. Likewise, the incidence of early ABMR and lesion score characteristics were comparable between sCD30-positive and sCD30-negative patients with DSA. Finally, increased sCD30 levels were not predictive for early persistence of DSA. Conclusion: Preformed DSA are associated with an increased risk for ABMR and long-term graft loss independent of sCD30 levels in intermediate-risk kidney transplant patients.
Authors with CRIS profile
Christian Bach
Department of Medicine 5 – Haematology and Oncology
Bernd Spriewald
Department of Medicine 5 – Haematology and Oncology
Maike Büttner-Herold
Department of Nephropathology
Involved external institutions
Germany (DE)How to cite
APA:
Drasch, T., Bach, C., Luber, M., Spriewald, B., Utpatel, K., Büttner-Herold, M.,... Zecher, D. (2021). Increased Levels of sCD30 Have No Impact on the Incidence of Early ABMR and Long-Term Outcome in Intermediate-Risk Renal Transplant Patients With Preformed DSA. Frontiers in Medicine, 8. https://dx.doi.org/10.3389/fmed.2021.778864
MLA:
Drasch, Thomas, et al. "Increased Levels of sCD30 Have No Impact on the Incidence of Early ABMR and Long-Term Outcome in Intermediate-Risk Renal Transplant Patients With Preformed DSA." Frontiers in Medicine 8 (2021).
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