HLA antibodies and soluble CD30 are associated with poor renal graft outcome: updated results of a single-center cross-sectional study

In a previous study, we have shown that HLA class II antibodies and a high soluble CD30 (sCD30) measured at least 1 year post-transplant predict subsequent graft failure. We have now updated the results of this same cohort of 208 patients 15 months later. HLA-specific antibodies (class I and class I...

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Bibliographic Details
Published inClinical transplants p. 219
Main Authors Langan, Leanne L, D'Orsogna, Lloyd, Park, Lawrence P, Hughes, Tiffany L, Irish, Ashley, Luxton, Grant, Witt, Campbell S, Christiansen, Frank T
Format Journal Article
LanguageEnglish
Published United States 2006
Subjects
Antigens, CD - blood
Cross-Sectional Studies
Enzyme-Linked Immunosorbent Assay
Follow-Up Studies
HLA Antigens - immunology
HLA-D Antigens - immunology
Humans
Isoantibodies - blood
Ki-1 Antigen - blood
Kidney Transplantation - immunology
Kidney Transplantation - mortality
Survival Analysis
Time Factors
Treatment Failure
Treatment Outcome
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Summary:In a previous study, we have shown that HLA class II antibodies and a high soluble CD30 (sCD30) measured at least 1 year post-transplant predict subsequent graft failure. We have now updated the results of this same cohort of 208 patients 15 months later. HLA-specific antibodies (class I and class II) were detected by ELISA LAT-M and Luminex LabScreen assays. Data on graft outcome was collected with a median follow-up of 4.7 years. By Kaplan-Meier analysis, class II antibody was again associated with a poorer outcome, with an estimated 6-year graft survival of 67% and 71% when detected by ELISA and Luminex, respectively, compared with 92% for those without class II antibody (p < or = 0.0001). A soluble CD30 level of > or = 100 U/ml was also associated with a poorer estimated 6-year graft survival (p = 0.02). HLA antibodies and high sCD30 (> or = 100 U/ml) had an additive effect such that those with both high sCD30 and class II antibodies had a hazard ratio for subsequent graft failure of 18.1 (p = 0.0008) and 8.6 (p = 0.007) when detected by ELISA and Luminex, respectively. These data show that detection of HLA class II antibodies and serum sCD30 measured at least 1 year post-transplant continues to predict a subsequent outcome up to 6 years after the initial measurement; they also show that such measures provide important information that may allow for modification of ongoing therapy.
ISSN:0890-9016