Objective To explore the significance of serum CD30 in predicting acute rejection and pneumonia in kidney transplant recipients. Methods A total of 106 kidney transplant recipients were recruited in this prospective six months follow-up study from December 2011 to October 2013. According to the clinical outcome, the subjects were devided into stable renal function group (52 cases), acute rejection group (34 cases) and pulmonary infection group (20 cases). Twenty healthy subjects were choosed as controls. Serum sCD30 levels were detected by ELISA. The whole peripheral blood samples were collected from all recipients before transplantation, at days 7, 14, 21 and 28 post-transplantation, and at months 2, 3, 4, 5 and 6 post-transplantation. Additional blood samples were collected for on the days that acute rejection or infection occurred and reversed. Results When acute rejection occurred, serum sCD30 levels in AR group was 50.38 ± 12.10 ng/mL, which was significantly higher than stable group (20.03± 6.68 ng/mL, P<0.05) and healthy control group (13.57±5.56 ng/mL, P<0.05). After the anti-rejection therapy, serum sCD30 levels decreased to 15.31 ± 6.37 ng/mL, which was lower than that before the therapy started (50.38 ± 12.10 ng/mL, P<0.05). Elevated preoperative serum sCD30 levels suggested a higher risk of acute rejection in kidney transplant recipients, with Cutoff values of 24.96 ng/mL, and the sensitivity and specificity were 91.30% and 84.21% respectively. Whereas, preoperative sCD30 levels in pulmonary infection group were lower than stable group (21.34±8.65 ng/mL vs 26.51 ± 13.70 ng/mL, P<0.05), and a significant correlation was observed between high levels of sCD30 and lower incidence of infection, with Cutoff values of 18.19 ng/mL, and the sensitivity and specificity were 87.10% and 71.43% respectively. Conclusion Our data suggest that dynamic monitoring of sCD30 levels can predict and assess the risks of rejection and infection episodes in kidney transplant recipients.

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