Urinary Chemokine CXCL-10 in Long Term Renal Transplant Patients Associates with Urinary Tract Infections and Microvascular Damage
1Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
2The Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
Meeting: 2018 American Transplant Congress
Abstract number: A122
Keywords: Biopsy, Graft function, Kidney transplantation, Rejection
Session Information
Session Name: Poster Session A: Kidney Acute Antibody Mediated Rejection
Session Type: Poster Session
Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Non-invasive biomarkers are needed to predict rejection post kidney transplantation. In the early transplant period, urinary CXCL-9 and CXCL-10 associate with rejection. We assessed the clinical use of urinary chemokines evaluation in long-term transplant patients for rejection. Bacterial and viral urinary tract infections (UTI) are associated with elevated chemokines levels. We assessed the impact of adenovirus on urinary chemokines.
From November 2015 – 2016, 185 urine samples from renal transplant patients (n=120) were screened over a median of 47 (2-400) months post transplant. Patients were followed until November 2017 to determine if biopsies confirmed rejection. 15 biopsies were done and scored by Banff criteria (8 acute cellular rejection, 2 mixed cellular/microvascular damage, 3 isolated microvascular damage and 3 transplant glomerulopathy (TG)). Urine was tested for viral and bacterial UTI's.
CXCL-9/urinary creatinine ratio (UCR) did not differentiate between stable graft function or rejection in this cohort.
CXCL-10/UCR was elevated in patients with bacterial UTI's and polyoma viruria (7.6 vs. 16.1 ng/mmoL, p=0.0355). CXCL-10/UCR was also elevated in patients with adenovirus (7.57 vs. 156 ng/mmoL, p =0.0006).
CXCL-10/UCR values were higher in acute cellular rejection as compared to stable patients (p<0.001). Values were higher in those who were diagnosed with TG or microvascular damage compared to stable graft function (p=0.005). The ROC curves were significant p=0.005 with AUC=0.66. Sensitivity- specificity analysis revealed a cut-off point of 3.7 ng/mmoL to differentiate between microvascular damage and stable graft function, specificity 94%, sensitivity 30%.
In long-term transplant patients, higher CXCL-10/UCR indicates microvascular damage.. CXCL-10/UCR is elevated in patients with viruria or bacteriuria and thus this needs to be taken into account when using CXCL-10/UCR to guide management . Additional research is needed to further clarify the clinical utility CXCL-10/UCR to stratify rejection risk in transplant patients.
CITATION INFORMATION: Irish G., Hockley M., Kireta S., Johnson J., Carroll R. Urinary Chemokine CXCL-10 in Long Term Renal Transplant Patients Associates with Urinary Tract Infections and Microvascular Damage Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Irish G, Hockley M, Kireta S, Johnson J, Carroll R. Urinary Chemokine CXCL-10 in Long Term Renal Transplant Patients Associates with Urinary Tract Infections and Microvascular Damage [abstract]. https://atcmeetingabstracts.com/abstract/urinary-chemokine-cxcl-10-in-long-term-renal-transplant-patients-associates-with-urinary-tract-infections-and-microvascular-damage/. Accessed May 13, 2025.« Back to 2018 American Transplant Congress