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Abstract
We investigated the clinical relevance of urinary cytokines/chemokines reflecting intrarenal immunologic micromilieu as prognostic markers and the optimal measurement timing after living donor kidney transplantation (LDKT). This prospective cohort study included 77 LDKT patients who were followed for ≥ 5 years. Patients were divided into control (n = 42) or acute rejection (AR, n = 35) group. Early AR was defined as AR occurring within 3 months. Serum and urine cytokines/chemokines were measured serially as follows: intraoperative, 8/24/72 h, 1 week, 3 months, and 1 year after LDKT. Intrarenal total leukocytes, T cells, and B cells were analyzed with immunohistochemistry followed by tissueFAXS. Urinary MCP-1 and fractalkine were also analyzed in a validation cohort. Urinary MCP-1 after one week was higher in the AR group. Urinary MCP-1, fractalkine, TNF-α, RANTES, and IL-6 after one week were significantly higher in the early AR group. Intrarenal total leukocytes and T cells were elevated in the AR group compared with the control group. Urinary fractalkine, MCP-1, and IL-10 showed positive correlation with intrarenal leukocyte infiltration. Post-KT 1 week urinary MCP-1 showed predictive value in the validation cohort. One-week post-KT urinary MCP-1 may be used as a noninvasive diagnostic marker for predicting AR after LDKT.
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1 Sungkyunkwan University School of Medicine, Division of Nephrology, Department of Medicine, Samsung Medical Center, Seoul, Republic of Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X)
2 Sungkyunkwan University, Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Seoul, Republic of Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X)
3 Korea Basic Science Institute, Research Center for Materials Analysis, Daejeon, Republic of Korea (GRID:grid.410885.0) (ISNI:0000 0000 9149 5707)
4 Sungkyunkwan University School of Medicine, Department of Surgery, Samsung Medical Center, Seoul, Republic of Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X)
5 Samsung Medical Center, Statistics and Data Center, Seoul, Republic of Korea (GRID:grid.414964.a) (ISNI:0000 0001 0640 5613)
6 Sungkyunkwan University School of Medicine, Department of Pathology, Samsung Medical Center, Seoul, Republic of Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X)