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Inflammation After Kidney Transplantation Is Associated With Overall- And Death-censored Graft Loss

T. F. Heldal, T. Jenssen, A. Hartmann, K. Heldal, A. Asberg

Department of Transplantational Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway

Meeting: 2022 American Transplant Congress

Abstract number: 9082

Keywords: Graft survival, Immunosuppression, Inflammation, Kidney transplantation

Topic: Basic Science » Basic Clinical Science » 17 - Biomarkers: Clinical Outcomes

Session Information

Session Name: Biomarkers: Clinical Outcomes

Session Type: Poster Abstract

Date: Tuesday, June 7, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Early graft loss after kidney transplantation (KT) is mainly a result of acute rejection, while long-term graft loss episodes are often dependent on multifactorial conditions. Both short- and long-term graft survival have improved in the last decade, however, the short-term results are still superior to the long-term outcomes. In this study we wanted to explore if patients with subclinical inflammation 10 weeks after KT had increased risk of long-term graft loss (GL).

*Methods: We measured 21 inflammatory biomarkers 10 weeks after KT in 1044 patients without any sign of acute inflammation and/or ongoing rejection episodes. Low-grade inflammation was assessed as composite inflammation scores: one overall inflammation score, and additionally five pathway-specific scores (table 1). The scores were tested in Cox regression models adjusted for traditional risk factors.

*Results: During the study period, 410 (39.3%) patients experienced overall GL, and of these 145 (35.6%) were death-censored GL. The overall inflammation score was significantly associated with overall GL (2nd quartile HR 1.60, p=0.001, 3rd quartile HR 1.87, p<0.001, 4th quartile HR 3.54, p<0.001), and with death-censored GL (2ndquartile HR 1.22, p= 0.504, 3rd quartile HR 1.78, p=0.049, 4th quartile HR 3.32, p<0.001) (figure 1 and 2). The same pattern was present for the pathway-specific scores and overall GL, whereas only fibrogenesis, vascular-, and metabolic inflammation showed a significant association with death-censored GL.

*Conclusions: It appears to be a strong association between subclinical general inflammation in the early period after KT and both long-term overall- and death-censored GL. These results establish the foundation for future studies on follow-up strategies and possibly new therapeutic approaches.

Cox Regression model showing the association between inflammation scores and overall graft loss
Pathway-specific inflammationscores HazardRatio (p-value)
2nd Quartile 3rd Quartile 4th Quartile
Fibrogenesis 1.65 (p=0.008) 1.75 (p=0.003) 2.49 (p<0.001)
Vascular inflammation 1.10 (p=0.580) 1.85 (p<0.001) 2.38 (p<0.001)
Metabolic inflammation 1.60 (p=0.004) 1.45 (p=0.023) 1.89 (p<0.001)
Angiogenesis 1.35 (p=0.038) 1.07 (p=0.652) 1.31 (p=0.080)
Leukocyte activation 1.19 (p=0.267) 1.41 (p=0.028) 1.71 (p<0.001)

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To cite this abstract in AMA style:

Heldal TF, Jenssen T, Hartmann A, Heldal K, Asberg A. Inflammation After Kidney Transplantation Is Associated With Overall- And Death-censored Graft Loss [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/inflammation-after-kidney-transplantation-is-associated-with-overall-and-death-censored-graft-loss/. Accessed May 30, 2025.

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