The anaphylatoxin C5a, a new parameter in the diagnosis of renal allograft rejection

Transplant International : Official Journal of the European Society for Organ Transplantation
T F MüllerH Lange

Abstract

In the underlying study the diagnostic value of the anaphylatoxin C5a was evaluated in kidney transplantation. In 49 transplant patients the following parameters were measured daily for a mean period of 25.1 days: plasma C5a [P-C5a], urine C5a [U-C5a], serum amyloid A [SAA], serum neopterin [S-NEOP] and urine neopterin [U-NEOP]. Sensitivity, specificity and day of first significant parameter increase (exceeding a cut-off level of > 50%) were evaluated retrospectively during 30 periods of rejection and 30 periods of stable graft function. U-C5a was the parameter with the highest sensitivity (84%) and specificity (84%), increasing in the mean 1.3 days before clinical diagnosis of rejection. Sensitivity and specificity of the other markers was lower: SAA 77% and 77%, U-NEOP 68% and 65%, S-NEOP 45% and 77%, and P-C5a 45% and 48%, respectively. During four instances of cytomegalovirus disease extremely high U-NEOP (> or = 1520 +/- 518 mumol/mol creatinine) and slightly increased P-C5a levels (> or = 1.5 +/- 1.4 ng/ml) occurred. Elevated urinary excretion of C5a seems to be a reliable and early marker of renal allograft rejection. In combination with SAA and U-NEOP, the daily assessment of U-C5a differentiates between viral infection...Continue Reading

References

Dec 1, 1991·Clinical and Experimental Immunology·H E FeuchtE Albert
Dec 1, 1991·Transplantation·J L Platt, F H Bach
Feb 1, 1988·Scandinavian Journal of Immunology·T E Mollnes, P J Lachmann
Dec 1, 1982·The Journal of Clinical Investigation·R O WebsterP M Henson
Jun 1, 1993·Kidney International·H E FeuchtE Albert
Jul 1, 1995·Molecular Medicine Today·P A AndrewsS H Sacks

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Citations

Nov 26, 1999·Kidney International·P W PeakeJ A Charlesworth
Jun 2, 1998·Kidney International·B J Ballermann
Mar 17, 2012·Transplant International : Official Journal of the European Society for Organ Transplantation·Eugenia K PageStuart J Knechtle

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