Soluble CD30, Acute Rejection, and Graft Survival: Pre- and 6-Month Post-Transplant Determinations-When Is the Best Time to Measure?

BACKGROUND: Pretransplantation soluble CD30 (sCD30) has been shown to be a good predictor of acute rejection (AR) and graft loss. This study aimed to evaluate the effectiveness of sCD30 measured pretransplant and up to 6 months after transplantation as a predictor of AR, graft loss, and survival at 5 years post-transplantation. Subjects were patients receiving living donor renal transplants at Bonsucesso Federal Hospital (Rio de Janeiro) in 2006 and between August 2010 and May 2011. METHODS: sCD30 was analyzed in samples collected pretransplantation and 7, 14, and 21, 28 days and 3, 4, 5, and 6 months post-transplantation from 73 kidney recipients. RESULTS: Patients in the AR group did not present a positive correlation with the sCD30 levels pretransplant (P = .54); in the post-transplant period, the 7- to 14-day samples showed patients with AR had higher levels of this biomarker (P = .036). The graft survival in 5 years of follow-up was not different between groups. CONCLUSIONS: The best time to predict AR using sCD30 is the 7- to 14-day sample; however, identifying and following the decrease of this biomarker from pre- to post-transplant seems to be better than just 1 measurement. The sCD30 post-transplant is another tool that may be used in monitoring patients after renal transplantation.

One living donor and two donations: sequential kidney and liver donation with 20-years interval.

The shortage of cadaveric donor organs remains the critical factor limiting the use of organ transplantation. In this environment of organ shortage, living donor transplantation has emerged as a reasonable therapeutic alternative. Simultaneous kidney-liver transplantation from the same donor has been described. We report a case of right liver lobe transplant from a living donor who had donated his kidney to the same recipient 20 years prior.

Tuberculosis in renal transplants in Rio de Janeiro.

Retrospective analysis of 982 renal transplants over 21 years (1981 to 2002) sought to evaluate the prevalence of tuberculosis (TB). This analysis included 74 patients: 30 with a past TB history, who had INH prophylaxis since the beginning of immunosuppression, and 44 who only became TB infected after receiving transplants. The diagnosis of TB was made by a compatible medical situation with bacteriological/histological confirmation, which when not possible, underwent a therapeutic test occur. The average time for the illness to surge was 3 years. The mortality rate was 34.9% (15/44). Patients with hepatitis C were more affected. Among those who used INH prophylaxis only one contracted TB, showing that the drug displayed a protection rate of 96.6% (29/30).