Abstract
Background and Aims
T cell immunoglobulin and mucin domain (Tim-3) and its ligand, galectin-9 (Gal-9), play an important role in immune regulation. Serum soluble Tim-3 (sTim-3) and Gal-9 (sGal-9) were observed to be correlated with renal function after kidney transplantation in our previous study, but whether these two could predict the adverse outcomes after transplantation is unknown.
Method
91 recipients receiving kidney transplantation were enrolled in this cohort study. 20 of all recipients suffered composite outcomes after kidney transplantation within two years. 71 recipients had stable renal function during this period. The expressions of sTim-3 and sGal-9 before and one month after transplantation were measured by ELISA.
Results
The level of sTim-3 before transplantation was significantly higher in recipients with stable renal function than composite outcomes (Median: range, 2275: 840-4236 pg/ml vs 1589: 353-3094 pg/ml, P=0.002, shown in Figure 1). The level of sGal-9 after transplantation was significantly lower in stable group than composite outcome group (Median: range, 4869: 1418-13080 pg/ml vs 6852: 4128-10760 pg/ml, P=0.003, shown in Figure 1). Area under curve (AUC) of sTim-3 before transplantation was 0.737 (P=0.002, shown in Figure 2) through the analysis of receiver operating characteristic curve (ROC curve). AUC of sGal-9 after transplantation was 0.751 (P=0.003, shown in Figure 2). After survival analysis, the percentage of recipients free from composite outcomes was significantly lower in patients with low level of sTim-3 than high sTim3 (P<0.0001, shown in Figure 3), so was in patients with high sGal-9 than low sGal-9 (P=0.0004, shown in Figure 3).
Conclusion
Serum sTim-3 and sGal-9 could predict the adverse outcomes within two years after kidney transplantation.
A Kidney Transplant Recipient with Recurrent Henoch-Schönlein Purpura Nephritis Successfully Treated with Steroid Pulse Therapy and Epipharyngeal Abrasive Therapy
