PS 07-17 DETECTION OF ENDOTHELIAL CELL SPECIFIC MOLECULE-1 ACCORDING TO ALLOGRAFT STATUS AFTER KIDNEY TRANSPLANTATION

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Abstract

Objective:

ESM-1 (endothelial specific molecule-1) is exclusively secreted from vascular endothelial cells. In patients with hypertension and chronic kidney disease, plasma ESM-1 correlated with disease severity and outcomes. We measured plasma and urine ESM-1 (endothelial cell specific molecule-1) level from renal allograft recipients to investigate whether there is the difference in ESM-1 level according to allograft status.

Design and Method:

We measured plasma and urine ESM-1 in 153 patients who underwent KTP. The concentration of ESM-1 was analyzed by commercial enzyme linked immunosorbent assay kit. Patients were divided into 6 different groups based on their allograft status; stable, acute tubular necrosis (ATN), acute cellular rejection (ACR), acute antibody-mediated rejection (aABMR), long term good survival (LTGS), and chronic active antibody-mediated rejection (cABMR). We compared plasma and urine ESM-1 levels among different groups.

Results:

Plasma ESM-1 level was higher in aABMR group than in stable, ATN and ACR group. cABMR group showed higher plasma ESM-1 levels than LTGS. Similar results were observed in urine analysis; urine ESM-1 levels were significantly higher in aABMR group compared to stable, ATN and ACR groups. Urine ESM-1 level was also higher in cABMR group than LTSG group. Patients with high plasma and/or urine ESM-1 levels showed severe glomerulitis, peritubular capillaritis and microvascular inflammation score, which are the hallmarks of ABMR.

Conclusions:

Plasma and urine ESM-1 could be a surrogate marker for the differential diagnosis of ABMR.

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