Activation of final complement components after kidney transplantation as a marker of delayed graft function severity.

Autor: Arias-Cabrales CE; Department of Nephrology, Hospital del Mar, Barcelona, Catalunya, Spain., Riera M; Department of Nephrology, Hospital del Mar, Barcelona, Catalunya, Spain.; Institut Hospital del Mar d'Investigacions Mèdiques, IMIM, Barcelona, Catalunya, Spain., Pérez-Sáez MJ; Department of Nephrology, Hospital del Mar, Barcelona, Catalunya, Spain., Gimeno J; Department of Pathology, Hospital del Mar, Barcelona, Catalunya, Spain., Benito D; Department of Nephrology, Hospital del Mar, Barcelona, Catalunya, Spain.; Institut Hospital del Mar d'Investigacions Mèdiques, IMIM, Barcelona, Catalunya, Spain., Redondo D; Department of Nephrology, Hospital del Mar, Barcelona, Catalunya, Spain., Burballa C; Department of Nephrology, Hospital del Mar, Barcelona, Catalunya, Spain., Crespo M; Department of Nephrology, Hospital del Mar, Barcelona, Catalunya, Spain., Pascual J; Department of Nephrology, Hospital del Mar, Barcelona, Catalunya, Spain., Rodríguez E; Department of Nephrology, Hospital del Mar, Barcelona, Catalunya, Spain.
Jazyk: angličtina
Zdroj: Clinical kidney journal [Clin Kidney J] 2020 Oct 10; Vol. 14 (4), pp. 1190-1196. Date of Electronic Publication: 2020 Oct 10 (Print Publication: 2021).
DOI: 10.1093/ckj/sfaa147
Abstrakt: Background: Ischaemia-reperfusion (I/R) damage is a relevant cause of delayed graft function (DGF). Complement activation is involved in experimental I/R injury, but few data are available from kidney transplant (KT) patients. We studied the dynamics of membrane attack complex (C5b-9) as a soluble fraction (SC5b-9) and the histological deposit pattern of C3b, complement Factor H (FH) and C5b-9 in DGF patients.
Methods: We evaluated SC5b-9 levels in 59 recipients: 38 with immediate graft function and 21 with DGF. The SC5b-9 was measured at admission for KT and 7 days after KT. DGF-kidney biopsies ( n  = 12) and a control group of 1-year protocol biopsies without tissue damage ( n  = 4) were stained for C5b-9, C3b and FH.
Results: SC5b-9 increased significantly in DGF patients (Day 0: 6621 ± 2202 mAU/L versus Day 7: 9626 ± 4142  mAU/L; P = 0.006), while it remained stable in non-DGF patients. Days 0-7 increase >5% was the better cut-off associated with DGF versus non-DGF patient discrimination (sensitivity = 81%). In addition, SC5b-9 increase was related to DGF duration and worse graft function, and independently associated with DGF occurrence. SC5b-9, C3b and FH stains were observed in tubular epithelial cells basal membrane. DGF-kidney biopsies showed a more frequently high-intensity stain, a higher number of tubules with positive stain and larger perimeter of tubules with positive stains for SC5b-9, C3b and FH than control patients.
Conclusions: Both SC5b-9 levels and SC5b-9, C3b and FH deposits in tubular epithelial cells basal membrane are highly expressed in patients experiencing DGF. SC5b-9 levels increase could be useful as a marker of DGF severity.
(© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA.)
Databáze: MEDLINE
Externí odkaz: