Clinical immunology
Preliminary study evaluating the risk factors of kidney acute rejection

Jacek Karczewski, Marek Karczewski, Krzysztof Wiktorowicz

(Centr Eur J Immunol 2011; 36 (4): 233-236)

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Background: Acute rejection episodes (ARE) are a major determinant of renal allograft survival and still a major challenge for contemporary transplantation. Finding the factors contributing to ARE could help to determine the high-risk patients and greatly improve the transplantation outcomes by applying proper immunosuppressive drug regimens. The aim of this preliminary study was to evaluate various epidemiological, clinical and immunological parameters as potential risk factors increasing the probability of ARE occurrences.

Material and methods: The study included 44 patients undergoing kidney transplantation. During the 3-month period following the transplantation, ARE was diagnosed in 11 patients. Baseline clinical and epidemiological characteristics was examined. Baseline serum concentrations of IL-2, IL-4, IL-5, IL-10, IFN-γ, TNF-α were measured by means of flow cytometry. The logistic analysis was also performed to identify the potential risk factors.

Results : No significant differences in epidemiological and clinical baseline characteristics of NONARE (non-rejection patients) and ARE patients were observed. Cytometric analysis of serum Th1/Th2 cytokines showed significant differences in baseline concentrations of IFN-γ and IL-10 in NONARE vs. ARE patients (p < 0.05). Conducted logistic regression showed that age of the recipient and baseline serum concentrations of INF-γ, IL-10, IL-4 can be considered as risk factors of ARE. The calculated odds ratios (Exp(B)) were, as follows: age Exp(B) = 0.9, IFN-γ Exp(B) = 2.49, IL-10 Exp(B) = 2.41, and IL-4 Exp(B) = 0.11. Model classification was correct in 84.1% predictions.

Conclusions : Conducted analysis indicates that young age of the recipient and baseline serum concentrations of IFN-γ, IL-10 and IL-4 can be considered as risk factors for ARE.

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