Pre-transplant immune state defined by serum markers and alloreactivity predicts acute rejection after living donor kidney transplantation

Acute rejection (AR) remains a major cause for long‐term kidney allograft failure. Reliable immunological parameters suitable to define the pre‐transplant immune state and hence the individual risk of graft rejection are highly desired to preferably adapt the immunosuppressive regimen in advance. Do...

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Bibliographic Details
Published in:Clinical transplantation 2014-09, Vol.28 (9), p.968-979
Main Authors: Vondran, Florian W.R., Timrott, Kai, Kollrich, Sonja, Steinhoff, Ann-Kristin, Kaltenborn, Alexander, Schrem, Harald, Klempnauer, Juergen, Lehner, Frank, Schwinzer, Reinhard
Format: Article
Language:English
Subjects:
acute rejection
Adult
Biomarkers - blood
CD161
CD4-Positive T-Lymphocytes - immunology
CD8-Positive T-Lymphocytes - immunology
Enzyme-Linked Immunosorbent Assay
Female
Flow Cytometry
Follow-Up Studies
Graft Rejection - blood
Graft Rejection - diagnosis
Humans
Hyaluronan Receptors - blood
Interleukin-2 Receptor alpha Subunit - blood
Ki-1 Antigen - blood
Kidney Failure, Chronic - immunology
Kidney Failure, Chronic - surgery
Kidney Transplantation
Living Donors
Lymphocyte Activation
Lymphocyte Culture Test, Mixed
Male
Middle Aged
Postoperative Care
Predictive Value of Tests
Risk Factors
sCD25
sCD30
sCD44
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Summary:Acute rejection (AR) remains a major cause for long‐term kidney allograft failure. Reliable immunological parameters suitable to define the pre‐transplant immune state and hence the individual risk of graft rejection are highly desired to preferably adapt the immunosuppressive regimen in advance. Donor and third party alloreactivities were determined by mixed lymphocyte cultures. Soluble forms of CD25, CD30, and CD44 were detected in patients' serum by ELISA. Various lymphocyte subpopulations were measured using flow cytometry. All patients received triple immunosuppression (tacrolimus/mycophenolate mofetil/steroids) and were grouped according to biopsy results within the first year: rejection‐free (RF, n = 13), borderline (BL, n = 5), or acute rejection (AR, n = 7). Patients with AR showed the highest pre‐transplant alloreactivities and serum levels (sCD25/sCD30/sCD44) according to the pattern RF 
ISSN:0902-0063
1399-0012
DOI:10.1111/ctr.12399