Pretransplantation Soluble CD30 Level As a Predictor of Acute Rejection in Kidney Transplantation

Chen, Yile; Tai, Qiang; Hong, Shaodong; Kong, Yuan; Ya-zhen, Shang; Liang, Wenhua; Guo, Zhiyong; He, Xiaoshun

doi:10.1097/tp.0b013e31826784ad

Cited by 36 publications

(19 citation statements)

References 39 publications

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“…106,107 A meta-analysis concluded that the soluble CD30 marker showed only poor accuracy to predict acute rejection rates in the context of renal transplantation. 108 Another approach to assess cell-mediated immune responses is the measurement of intracellular adenosine-tri-phosphate production (iATP). Interestingly, individual levels of iATP correlated with rates of infections and cellular rejections in a meta-analysis of >500 solid organ transplant recipients, 109 independently of drug trough levels.…”

Section: Introductionmentioning

confidence: 99%

A Rationale for Age-Adapted Immunosuppression in Organ Transplantation

et al. 2015

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Demographic changes are associated with a steady increase of older patients with end-stage organ failure in need for transplantation. As a result, the majority of transplant recipients are currently older >50 years and organs from elderly donors are more frequently utilized. Nevertheless, the benefit of transplantation in older patients is well recognized whereas the most frequent causes of death among older recipients are potentially linked to side effects of their immunosuppressants. Immunosenescence is a physiological part of aging linked to higher rates of diabetes, bacterial infections and malignancies representing the major causes of death in older patients. These age-related changes impact older transplant candidates and may have significant implications for an age-adapted immunosuppression. For instance, immunosenescence is linked to lower rates of acute rejections in older recipients while the engraftment of older organs has been associated with higher rejection rates. Moreover, new-onset diabetes mellitus following transplantation is more frequent in the elderly, potentially related to corticosteroids, calcineurin inhibitors and mTOR inhibitors. This review presents current knowledge for an age-adapted immunosuppression based on both, experimental and clinical studies in and beyond transplantation. Recommendations of maintenance and induction therapy may help to improve graft function and to design future clinical trials in the elderly.

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Section: Introductionmentioning

confidence: 99%

A Rationale for Age-Adapted Immunosuppression in Organ Transplantation

et al. 2015

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“…In general, the pre-and post-transplant sCD30 concentrations were associated with a compromised kidney graft survival irrespective of antibody sensitization and HLA mismatches [51,59,60]. Although convincing data have been generated from the CTS trial, some other investigators were not able to repeat these findings [61][62][63]. This may be explained by differences in study designs, patients, and patient numbers.…”

Section: Scd30mentioning

confidence: 80%

“…The intra-individual variation of sCD30 over the post-transplantation period has been found to be considerable and differences in the immunosuppressive regimens, particularly in induction therapies, have been mentioned to contribute to biological variability [64,65]. A metaanalysis that was performed by Chen and colleagues challenged the finding that pretransplantation sCD30 was predictive of acute rejections [62]. An association between increased serum creatinine and sCD30 concentrations was reported, which brings up the question of…”

Section: Scd30mentioning

confidence: 95%

Lymphocyte surface molecules as immune activation biomarkers

Wieland

Shipkova

2016

Clinical Biochemistry

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“…Ein signifikant schlechteres Organüberleben wurde beobachtet, wenn am Tag 30 nach Transplantation Konzentrationen > 40 U/mL vorlagen [49]. Die vielversprechenden Ergebnisse mit sCD30 ließen sich nicht immer reproduzieren [50][51][52], was unter anderem an der hohen intraindividuellen Variation des Markers liegen könnte [53]. Die sCD30-Konzentrationen schwankten um ca.…”

Section: Lösliches Cd30 Im Serum (Scd30)unclassified

Biomarker im Blut zur Individualisierung der immunsuppressiven Therapie nach der Transplantation solider Organe

Wieland

Shipkova

2014

LaboratoriumsMedizin

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ZusammenfassungDie Erfolge der Transplantationsmedizin hängen eng mit der Entwicklung potenter Immunsuppressiva zusammen. Die Steuerung der Therapie mit den Calineurininhibitoren Ciclosporin und Tacrolimus sowie den mTOR (Nammalian target of rapamycin)-Inhibitoren Sirolimus und Everolimus wird durch ein therapeutisches Drug Monitoring (TDM) unterstützt. Für andere Medikamente wie z.B. die Mycophenolsäure ist ein TDM bisher nicht etabliert. Es hat sich aber gezeigt, dass eine bessere Individualisierung der Therapie dabei helfen könnte eine Über- oder Unterimmunsuppression bei einzelnen Patienten zu vermeiden und das immer noch entäuschende Langzeitüberleben der Organe und Patienten zu verbessern. Daher werden weltweit Biomarker gesucht, die als Ergänzung zum TDM eine bessere Individualisierung der Therapie ermöglichen. Dabei kann es sich um pharmakodynamische Biomarker handeln, die unspezifisch den globalen Effekt der Therapie auf das Immunsystem erfassen oder, um Marker die sehr spezifisch direkt den phramakologischen Effekt messen. Unspezifische Biomarker verfolgen entweder den Grad der Immunaktivierung durch Messung der T- und B-Zellaktivierung, die Toleranzentwicklung z.B. durch Erfassung regulatorischer T-Zellen oder den Transplantschaden z.B. durch die Messung von DNS, die aus dem Spenderorgan in das Blut des Empfänger freigesetzt wird. Spezifische pharmakodynamische Biomarker wurden u.a. für die Bestimmung der pharmakologischen Wirkung der Mycophenolsäure, von Calineurininhibitoren und von mTOR-Inhibitoren publiziert. Das Feld der Biomarker als Ergänzung zum TDM für die Individualisierung der immunsuppressiven Therapie ist noch in den Anfängen und es werden prospektive Studien benötigt, die das Potenzial von Biomarkern oder Biomarkerkombinationen in verschiedenen Patientenkollektiven mit unterschiedlichen Transplantaten beweisen oder verwerfen.

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Pretransplantation Soluble CD30 Level As a Predictor of Acute Rejection in Kidney Transplantation

Abstract: The results of the meta-analysis show that the accuracy of pretransplantation sCD30 for predicting posttransplantation AR was poor. Prospective studies are needed to clarify the usefulness of this test for identifying risks of AR in transplant recipients.

Cited by 36 publications

References 39 publications

A Rationale for Age-Adapted Immunosuppression in Organ Transplantation

A Rationale for Age-Adapted Immunosuppression in Organ Transplantation

Lymphocyte surface molecules as immune activation biomarkers

Biomarker im Blut zur Individualisierung der immunsuppressiven Therapie nach der Transplantation solider Organe

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