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 April 4, 2020.
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