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Urinary CXCL10 Measurement in Late Renal Allograft Biopsies Predicts Outcome Even in Histologically Quiescent Patients

Authors :
Patricia Hirt-Minkowski
Helmut Hopfer
Caroline Wehmeier
Joelle Handschin
Stefan Schaub
Michael Dickenmann
Patrizia Amico
Source :
Transplantation Proceedings. 53:2168-2179
Publication Year :
2021
Publisher :
Elsevier BV, 2021.

Abstract

CXCL10 is a promising early noninvasive diagnostic marker for allograft rejection and predictive for long-term outcomes. However, its value when measured later in the posttransplant course has not yet been accurately analyzed.We investigated urinary CXCL10 in 141 patients from a prospective, observational renal transplant cohort with 182 clinically indicated allograft biopsies performed12 months posttransplant and corresponding urines. Urinary CXCL10 was retrospectively quantified on stored urines using the MSD V-Plex Chemokine Panel 1 sandwich immunoassay (Meso Scale Discovery). The primary outcome was a composite of allograft loss/renal function decline (30% estimated glomerular filtration rate [eGFR]-decrease between index biopsy and last follow-up).Seventy-two patients (51%) reached the primary outcome, and their urinary CXCL10 levels were significantly higher at the time of their biopsy compared with patients with stable allograft function (median 9.3 ng/mmol vs 3.3 ng/mmol, P.0001). Time-to-endpoint analyses according to high/low urinary CXCL10 demonstrated that low urinary CXCL10 (≤7.0 ng/mmol) was associated with 73% 5-year event-free graft survival compared with 48% with high urinary CXCL10 (7.0 ng/mmol; P = .0001). Even in histologically quiescent patients, high urinary CXCL10 was associated with inferior endpoint-free graft survival (P = .003), and it was an independent predictor of the primary outcome (P = .03).This study demonstrates that urinary CXCL10 has a promising diagnostic performance for detection of late allograft rejection and is an independent predictor of long-term renal allograft outcomes, even in histologically quiescent patients.

Details

ISSN :
00411345
Volume :
53
Database :
OpenAIRE
Journal :
Transplantation Proceedings
Accession number :
edsair.doi.dedup.....b8886c4688d6a3a8892dabf96bc61f14
Full Text :
https://doi.org/10.1016/j.transproceed.2021.07.013