Pretransplant serum levels of endothelial cell activation markers are associated with graft loss and mortality after kidney transplantation

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Long-term allograft survival remains a challenge in kidney transplantation. In this study, we aimed to identify biomarkers for potentially modifiable pathways involved in the outcome of kidney transplantation. We tested the hypothesis that a pre-existing systemic environment with endothelial cell activation in the recipient is associated with the outcome after kidney transplantation. In a retrospective study cohort of 611 kidney transplanted patients, we investigated associations between serum levels of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) before transplantation and delayed graft function, acute rejection, graft loss and mortality after transplantation. We adjusted associations for age, sex, preformed donor-specific antibodies (DSA), pretransplant diabetes, cardiovascular disease and dialysis. Additionally, we investigated if associations between endothelial cell activation markers and outcomes differed in recipients with and without preformed DSA. Serum levels of endothelial cell activation markers were associated with delayed graft function and mortality but not with rejection. Additionally, high levels of sICAM-1 were associated with graft loss. Associations were most pronounced in recipients without DSA, adjusted for potential confounders. Data suggest that endothelial cell activation at the time of transplantation is associated with graft loss and mortality after kidney transplantation, especially in transplant candidates without preformed DSA.

Original languageEnglish
Article numbere13225
JournalScandinavian Journal of Immunology
Volume97
Issue number1
Number of pages14
ISSN0300-9475
DOIs
Publication statusPublished - 2023

    Research areas

  • adhesion molecules, inflammation, solid organ transplantation, transplantation, SOLUBLE ADHESION MOLECULES, C-REACTIVE PROTEIN, ALLOGRAFT SURVIVAL, ACUTE REJECTION, E-SELECTIN, INFLAMMATION, VCAM-1, ICAM-1, ATHEROSCLEROSIS, INTERLEUKIN-6

ID: 326085635