Background: Chronic allograft dysfunction (CAD) is the most important clinical problem in solid organ transplantation. Interstitial fibrosis and tubular atrophy contribute to long term renal allograft failure. Urinary type III collagen, an amino-terminal propeptide (PIIINP) has been shown to associate fibrotic processes.

Methods: 160 patients with CAD that underwent allograft biopsies were evaluated and 52 patients with chronic/sclerosing allograft nephropathy were enrolled in the study. The subjects were divided into two groups according to the level of urine PIIINP/creatinine (u-PIIINP/Cr): High procollagen group and low procollagen group. The association between u-PIIINP/Cr at the time of biopsy and renal endpoints during 36 months of follow-up was assessed by multivariate Cox analysis.

Results: Interstitial fibrosis and proteinuria were higher in high procollagen group compared to low procollagen group. Correlation analysis showed that, levels of u-PIIINP/Cr were positively associated with fibrosis scores. During the follow-up, glomerular filtration rate (GFR) decreased in both study groups, however GFR decline in high procollagen group was higher than in low procollagen group. Cox regression model showed that u-PIIINP/Cr levels, GFR and 24 hour protein excretion were independent risk factors associated with graft survival.

Conclusion: u-PIIINP/Cr leve is a potential useful non invasive marker for graft survival in patients with CAD.

CITATION INFORMATION: Yilmaz R, Yildirim T, Baydar D, Altun B, Erdem Y. Urinary Type III Procollagen (PIIINP) Is Associated with Chronic Allograft Dysfunction and Predicts Graft Survival. Am J Transplant. 2017;17 (suppl 3).

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