الفهرس 
Kidney TransplantationOnly 14 pages are availabe for public view
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Abstract
Background: Transplantation is the first successful modality of renal
replacement therapy (RRT) for irreversible chronic kidney disease (CKD; stage 5).Identifying additional factors associated with poor long-term prognosis after transplantation may provide clues regarding the pathophysiological mechanisms involved in allograft failure and identify high-risk patients who may benefit from additional monitoring or interventions. Successful kidney transplantation results in a substantial decrease in β2-M levels, but a delayed decrease or increasing levels after transplantation may serve as a marker of acute rejection or inflammation. Several reports show that elevated sCD30 levels, pre and post transplantation are associated with a poor prognosis for long term kidney graft survival. These studies found higher CD30 levels in allograft recipients and a good predictor of impending acute rejection.Methods: 20 patients subjected to primary Tx.participated in this study.CD30 and β2-M were measured at day -1,2weeks and 3 months,with clinical follow up after 1 year to detect graft survival. According to our results ,patients were classified into 2 groups:group (A): including 16 patients had good graft function.group (B) including 4 Patients developed graft rejection.Results: At day -1,level of CD30 was higher in group(B) than group(A).2 weeks post transplantation ,level of CD30 was higher group(B) than group(A) and a 3 months post transplantation level of CD30 was higher in group(B) than group(A),and these differences are statistically highly significant.(p values :0.003,0.005 and 0.002 respectively)Successful transplantation leads to significant decrease in serum CD30 at 2 weeks post tx.(P1 <0.005) and at 3 months post tx. (P1<0.001) Although in group(B)significant decrease in CD30 was at 2 weeks post tx.only(P1<0.005) and at 3 months serum CD30 began to rise again with( P1 0.157). At day -1,level of β2-M was higher in group(B) than group(A) with statistically significant difference (p. 0.01).2 weeks post transplantation ,level of β2-M was higher in group(B) than group(A),but statistically not significant(p. 0.18 ) and at 3 months post transplantation level of β2- M was higher in group(B) than group(A),but statistically non significant(p. 0.18 ) .Successful transplantation leads to significant decrease in serum β2-M at 2 weeks post tx.(P1 <0.002) and at 3 months post tx. (P1<0.001) although in group(B),significant decrease in β2-M was at 3 months post tx.only(P1<0.005) and at 2 weeks no significant decrease(p1 0.15)Conclusions: Pre transplantation high CD30 and β2-M is associated with poor outcome.Failure of decrease of CD30 and β2-M post Tx. also associated with poor outcome or infection. Successful transplantation leads to significant decrease in serum CD30 and β2-M . which can be used as predictors of graft survival with better sensitivity and specificity than serum creatinine.