Pretransplant Numbers of CD16(+) Monocytes as a Novel Biomarker to Predict Acute Rejection After Kidney Transplantation: A Pilot Study
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Publication year
2017Source
American Journal of Transplantation, 17, 10, (2017), pp. 2659-2667ISSN
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Article / Letter to editor
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Organization
Nephrology
Journal title
American Journal of Transplantation
Volume
vol. 17
Issue
iss. 10
Page start
p. 2659
Page end
p. 2667
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Radboudumc 11: Renal disorders RIHS: Radboud Institute for Health SciencesAbstract
Acute rejection is one of the major immunological determinants of kidney graft function and survival. Early biomarkers to predict rejection are lacking. Emerging evidence reveals a crucial role for the monocyte/macrophage lineage cells in the pathogenesis of rejection. We hypothesized that higher pretransplant numbers of proinflammatory CD16+ monocytes can predict rejection. The study cohort consisted of 104 kidney transplant recipients (58 with no rejection and 46 with biopsy-proven rejection) and 33 healthy persons. Posttransplant median follow-up time was 14.7 mo (interquartile range 0.3-34 mo). Pretransplantation blood samples were analyzed by flow cytometry for monocyte immunophenotypes. Groups were compared by Cox regression models for the occurrence of acute rejection. We documented a significantly increased absolute number of pretransplant CD16+ monocytes in patients who developed biopsy-proven rejection after transplantation compared with those with no rejection (hazard ratio [HR] 1.60, 95% CI 1.28-2.00, p < 0.001) and healthy persons (HR 1.47, 95% CI 1.18-1.82, p < 0.001). In parallel, significantly fewer absolute numbers of CD16- monocytes were observed at pretransplant time points in rejectors versus nonrejectors (HR 0.74, 95% CI 0.58-0.94, p < 0,014). A higher pretransplant number of CD16+ monocytes is significantly associated with a higher risk of acute rejection after kidney transplantation.
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- Faculty of Medical Sciences [90373]
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