Osamu Soma1, Shingo Hatakeyama2, Tohru Yoneyama3, Mitsuru Saito4, Hideo Sasaki5, Yuki Tobisawa1, Daisuke Noro1, Yuichiro Suzuki1, Masakazu Tanaka6, Shin-Ichiro Nishimura6, Hiroshi Harada7, Hideki Ishida8, Kazunari Tanabe8, Shigeru Satoh4, Chikara Ohyama1,3. 1. Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. 2. Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. shingoh@hirosaki-u.ac.jp. 3. Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. 4. Department of Urology, Akita University Graduate School of Medicine, Akita, Japan. 5. Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan. 6. Frontier Research Centre for Advanced Material and Life Science, Graduate School of Life Science, Hokkaido University, Sapporo, Japan. 7. Department of Kidney Transplant Surgery, Sapporo City General Hospital, Sapporo, Japan. 8. Department of Urology, Tokyo Woman's Medical University, Tokyo, Japan.
Abstract
BACKGROUND: To evaluate whether serum N-glycan profile can be used as a diagnostic marker of graft rejection after living-donor kidney transplants (KT). METHODS: We retrospectively examined 174 KT recipients at five medical centers. N-Glycan levels were analyzed in postoperative serum samples using glycoblotting combined with mass spectrometry. We developed an integrated score to predict graft rejection based on a combination of age, gender, immunological risk factors, and serum N-glycan levels at post-KT day D1 and D7. Rejection-free survival rates stratified by the sum of integrated scores (D1 + D7) were evaluated using Kaplan-Meier curves. RESULTS: Of 174, 52 showed graft rejection (Rejection-pos. group) and 122 recipients did not show graft rejection (Rejection-neg. group). The integrated scores were significantly higher in the Rejection-pos. group than those of the Rejection-neg. group. Area-under-curve (AUC) value of integrated scores at post-KT D1, and D7 were 0.84 and 0.84, respectively. The sum of integrated scores (D1 + D7) ≥ 0.50 identified graft rejection with 81% sensitivity and 80% specificity; with an AUC value of 0.87. Recipients with higher sum of integrated scores (D1 + D7 ≥ 0.5) had significantly shorter rejection-free survival than those with lower scores. CONCLUSION: Evaluation of serum N-glycosylation profiles can identify recipients who are prone to rejection.
BACKGROUND: To evaluate whether serum N-glycan profile can be used as a diagnostic marker of graft rejection after living-donor kidney transplants (KT). METHODS: We retrospectively examined 174 KT recipients at five medical centers. N-Glycan levels were analyzed in postoperative serum samples using glycoblotting combined with mass spectrometry. We developed an integrated score to predict graft rejection based on a combination of age, gender, immunological risk factors, and serum N-glycan levels at post-KT day D1 and D7. Rejection-free survival rates stratified by the sum of integrated scores (D1 + D7) were evaluated using Kaplan-Meier curves. RESULTS: Of 174, 52 showed graft rejection (Rejection-pos. group) and 122 recipients did not show graft rejection (Rejection-neg. group). The integrated scores were significantly higher in the Rejection-pos. group than those of the Rejection-neg. group. Area-under-curve (AUC) value of integrated scores at post-KT D1, and D7 were 0.84 and 0.84, respectively. The sum of integrated scores (D1 + D7) ≥ 0.50 identified graft rejection with 81% sensitivity and 80% specificity; with an AUC value of 0.87. Recipients with higher sum of integrated scores (D1 + D7 ≥ 0.5) had significantly shorter rejection-free survival than those with lower scores. CONCLUSION: Evaluation of serum N-glycosylation profiles can identify recipients who are prone to rejection.
Authors: Isaak Quast; Christian W Keller; Michael A Maurer; John P Giddens; Björn Tackenberg; Lai-Xi Wang; Christian Münz; Falk Nimmerjahn; Marinos C Dalakas; Jan D Lünemann Journal: J Clin Invest Date: 2015-10-05 Impact factor: 14.808