Abstract: TH-PO809
Pretransplant Inflammatory Biomarkers Predict Death-Censored Graft Failure after Kidney Transplantation
Session Information
- Transplantation: Clinical - 2
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Lorenz, Elizabeth C., Baylor College of Medicine, Houston, Texas, United States
- Smith, Byron H., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Tapia, Amanda L., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Park, Walter, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Stegall, Mark D., Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background
Pre-transplant inflammatory biomarkers have previously been associated with adverse kidney transplant (KT) outcomes, including delayed graft function and acute rejection. The goal of this study was to determine if pre-KT inflammatory biomarkers are also associated with graft failure after KT.
Methods
We retrospectively measured inflammatory biomarker levels in serum collected up to 1 year prior to KT in recipients transplanted at Mayo Clinic in Rochester, Minnesota between 1/2006-12/2018.The following biomarkers were chosen based on their association with medical risk across multiple patient populations: interleukin-15 (IL-15), IL-1β, monocyte chemoattractant protein-1 (MCP-1), growth differentiation factor-15 (GDF-15), IL-6, monokine induced by gamma interferon/chemokine (C-X-C motif) ligand 9 (MIG/CXCL9), soluble FAS (sFAS), soluble tumor necrosis factor receptor-1 (sTNF-R1), and TNFα. Biomarker levels were normalized with Z-transformation. Kaplan-Meier estimation and Cox regression were used to examine the relationship between biomarkers and death-censored graft failure.
Results
Our cohort consisted of 1,595 KT recipients with a mean age of 52.0 ± 14.2 years; 62.9% were male and 83.2% were White. Over a mean follow-up of 7.4 ± 3.9 years, 10.4% of patients (n=166) experienced death-censored graft failure. Higher pre-KT levels of soluble tumor necrosis factor receptor-1 (sTNF-R1) were significantly associated with death-censored graft failure after adjusting for other biomarkers (HR 1.4 per standardized log-value, 95% CI 1.2-1.7, p=0.0006).
Conclusion
Pre-KT activation of TNF pathways may contribute to graft failure following KT. Measuring pre-KT serum concentrations of sTNF-R1 may help to risk stratify and manage patients undergoing KT.
Funding
- NIDDK Support