NIV Congres

Reliable biomarkers predicting the safe reduction of immunosuppression after renal transplantation are not available. Soluble CD30 (sCD30) levels have been demonstrated to be associated with graft survival and possibly also with the incidence of acute rejection after renal transplantation. We investigated if sCD30 can be used as a marker for safe withdrawal of tacrolimus at six months after renal transplantation. We prospectively studied a cohort of 82 patients with stable graft function who were treated with the combination of tacrolimus, azathioprine or mycophenolate mofetil, and prednisone. From six months after transplantation, tacrolimus was tapered and discontinued in a period of 4 weeks under close monitoring for acute rejection. Signs of acute rejection within 6 months after withdrawal of tacrolimus occurred in 30 of the 82 patients. In 24 rejectors and 44 non-rejectors the sCD30 concentration was determined in serum collected before transplantation and immediately before withdrawal of tacrolimus. The sCD30 concentration decreased significantly after transplantation (p<0.0001). There was no difference in sCD30 levels between rejectors and non-rejectors, neither pre transplantation (134,8 ± 66,2 ng/mL versus 149,8 ± 78,0 ng/mL; NS) nor pre withdrawal (63,4 ± 33,5 ng/mL versus 78,0 ± 73,9 ng/mL; NS). We conclude that soluble CD30 levels cannot be used to guide safe withdrawal of tacrolimus at 6 months after renal transplantation.