Galectin-3 and Long-Term Graft Failure in Renal Transplant Recipients: A Prospective Cohort Study

C. G. Sotomayor¹, C. A. Keyzer¹, J. L. Anderson¹, R. O. Gans², I. M. Nolte³, M. H. de Borst¹, S. P. Berger¹, G. J. Navis¹, R. A. de Boer⁴, S. J. Bakker¹

¹Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, Netherlands, ²Department of Internal Medicine, University Medical Center Groningen, Groningen, Netherlands, ³Department of Epidemiology, University Medical Center Groningen, Groningen, Netherlands, ⁴Department of Cardiology, University Medical Center Groningen, Groningen, Netherlands

Meeting: 2019 American Transplant Congress

Abstract number: 410

Keywords: Fibrosis, Graft failure, Renal failure

Session Information

Session Name: Concurrent Session: Kidney Complications: Late Graft Failure III

Session Type: Concurrent Session

Date: Tuesday, June 4, 2019

Session Time: 2:30pm-4:00pm

Presentation Time: 2:30pm-2:42pm

Location: Veterans Auditorium

*Purpose: Galectin-3 has been associated with renal fibrosis and decline of renal function. We aimed to determine the association of galectin-3 with long-term risk of death-censored graft failure in a large cohort of extensively phenotyped renal transplant recipients (RTR).

*Methods: We performed a longitudinal cohort study in 561 RTR with a functioning graft ≥1 year, recruited between 2001 and 2003 in a university setting. Galectin-3 levels were determined in serum samples (BG Medicine, Inc, Waltham, MA). Death-censored graft failure was defined as restart of dialysis or re-transplantation. Cox-proportional hazards regression analyses were performed to assess the association of galectin-3 with outcome.

*Results: Baseline median galectin-3 was 21.1 [interquartile range, 17.0‒27.2] ng/mL. During a median follow-up of 6.9 [6.2-7.5] years, 53 RTR developed graft failure. In multivariable-adjusted Cox regression analysis, galectin-3 was associated with death-censored graft failure (hazard ratio, 2.32 per 1-SD increase; 95% confidence interval, 1.68 to 3.20, P<0.001), independent of well-established general and renal transplant-specific risk factors, including estimated Glomerular Filtration Rate and proteinuria.

*Conclusions: In RTR, galectin-3 is elevated and independently associated with long-term risk of death-censored graft failure. Galectin-3 may be helpful to assess prognosis and guide existing therapy. Whether a novel galectin-3-targeted therapy may represent an opportunity to decrease the burden of long-term graft failure in stable RTR requires further studies.

Table 1. Prospective association of galectin-3 with graft failure.
Model	Gal-3, per 1─SD increase
Model	HR (95%CI)	P
Model 1	2.42 (1.90-3.07)	<0.001
Model 2	2.32 (1.68-3.20)	<0.001
Model 3	2.56 (1.79-3.65)	<0.001
Model 4	2.14 (1.51-3.04)	<0.001
Model 1: crude. Model 2: adjustment for recipient age, sex and BMI, donor age and sex, dialysis vintage, type of transplant, time since transplantation time-dependent eGFR and proteinuria. Model 3: model 2 + immunosuppressive therapy. Model 4: model 2 + cardiovascular risk factors.

To cite this abstract in AMA style:

Sotomayor CG, Keyzer CA, Anderson JL, Gans RO, Nolte IM, Borst MHde, Berger SP, Navis GJ, Boer RAde, Bakker SJ. Galectin-3 and Long-Term Graft Failure in Renal Transplant Recipients: A Prospective Cohort Study [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/galectin-3-and-long-term-graft-failure-in-renal-transplant-recipients-a-prospective-cohort-study/. Accessed November 21, 2024.

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