Early subclinical inflammation correlates with outcomes in positive crossmatch kidney allografts

Patrick G. Dean, Walter D. Park, Lynn D. Cornell, Carrie Schinstock, Mark D Stegall

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The aim of this study was to investigate correlations between early subclinical findings (10- and 90-day histology and gene expression data) and late outcomes (transplant glomerulopathy and graft loss) in positive crossmatch kidney transplants (+XMKTx). We compared 34 +XMKTx (19 receiving eculizumab and 15 receiving standard of care without eculizumab) to 13 −XMKTx (between August 2001 and August 2011). At 10 days, light microscopy identified subclinical inflammation in only 18% of +XMKTx, while intragraft gene expression identified inflammation in 79% (gene sets for activated macrophages, dendritic cells, NK cells or T cells). Inflammation persisted at 90 days and was associated with the development of transplant glomerulopathy by 2 years and graft loss. In contrast, endothelial cell (EC) changes present at 90 days by either electron microscopy or gene expression were not associated with transplant glomerulopathy or graft loss in this cohort. Eculizumab treatment did not appear to alter inflammation or EC changes. Therefore, intragraft inflammation might be an appropriate surrogate marker of progression and also a target of therapy to prevent chronic antibody-mediated rejection.

Original languageEnglish (US)
Pages (from-to)925-933
Number of pages9
JournalClinical Transplantation
Volume30
Issue number8
DOIs
StatePublished - Aug 1 2016

Fingerprint

Allografts
Inflammation
Transplants
Kidney
Gene Expression
Endothelial Cells
Standard of Care
Natural Killer Cells
Dendritic Cells
Microscopy
Histology
Electron Microscopy
Biomarkers
Macrophages
T-Lymphocytes
Light
Antibodies
Therapeutics
Genes
eculizumab

Keywords

  • antibody
  • gene expression
  • inflammation
  • kidney transplant
  • rejection

ASJC Scopus subject areas

  • Medicine(all)
  • Transplantation

Cite this

Early subclinical inflammation correlates with outcomes in positive crossmatch kidney allografts. / Dean, Patrick G.; Park, Walter D.; Cornell, Lynn D.; Schinstock, Carrie; Stegall, Mark D.

In: Clinical Transplantation, Vol. 30, No. 8, 01.08.2016, p. 925-933.

Research output: Contribution to journalArticle

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