Open AccessThe use of NGAL and IP ‐10 in the prediction of early acute rejection in highly sensitized patients following HLA ‐incompatible renal transplantation
Author(s) -
Field Melanie,
Lowe David,
Cobbold Mark,
Higgins Robert,
Briggs David,
Inston Nicholas,
Ready Andrew R.
Publication year - 2014
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12266
Subject(s) - medicine , transplantation , immunosuppression , biomarker , cohort , human leukocyte antigen , kidney transplantation , creatinine , hazard ratio , alloimmunity , lipocalin , gastroenterology , immunology , oncology , antigen , confidence interval , biochemistry , chemistry
Summary Acute rejection is a significant problem for patients undergoing HLA ‐incompatible renal transplantation, affecting between 12 and 53% of patients. Any mechanism of detecting rejection in advance of current methods would offer significant benefit. This study aimed to evaluate whether serum biomarkers could predict rejection in HLA i transplants recipients. Sera from 94 HLA i transplant recipients from a single centre were analysed for a panel of biomarkers including: NGAL , KIM ‐1, IP ‐10, cystatin C, cathepsin L and VEGF . Biomarker levels pre‐operatively, day 1 and at day 30 post‐transplant were correlated with the development of early rejection. Significantly higher levels of IP ‐10 and NGAL were seen on day 1 following transplant in those patients who developed acute rejection ( P < 0.001 and 0.005) and generated AUC of 0.73 and 0.67, respectively. No differences were seen for the other biomarkers or at the other time points. In this study cohort, IP ‐10 and NGAL have demonstrated good predictive ability for the development of acute rejection at a very early time point. They may have a role in identifying patients at higher risk for rejection and stratifying immunosuppression or surveillance.