SOLUBLE CD30 IN HEART TRANSPLANT RECIPIENTS Barbara Kauper,1 Kimberly P. Spells,1 Bhavna Lavingia,1 W. Steves Ring,2 Clyde Yancy, 1 Peter Stastny,1 Patricia Kaiser2, 1Internal Medicine, Univ of TX Southwestern Medical Center; 2Surgery, Univ of TX Southwestern Medical Center, Dallas, TX CD30, a member of the TNF receptor family is expressed on CD4⫹ and CD8⫹ T cells and B cells. Its expression was reported to mark the predominant proliferating T cell population induced by alloantigen and a role for CD30 interaction with its ligand CD153, in graft-versus-host disease has been observed. Several recent reports have shown that measurement of soluble CD30 (sCD30) in serum appears to be a useful indicator for predicting acute graft rejection in kidney transplant recipients. In this report of ongoing work, we have attempted to evaluate whether elevation of sCD30 is associated with rejection in heart transplant recipients. sCD30 was determined by ELISA in 121 sera obtained from 86 adult patients who received a heart transplant at our center between Jan 1998 and Jan 2002. Sera were collected at regular intervals on a protocol and biopsies were performed to evaluate rejection. We observed an elevated serum sCD30 at some time in 56/86 patients (65.1%), in 46 of them sCD30 was above normal levels already before transplantation. In most of the patients high levels of serum sCD30 persisted also after transplantation. Pre-transplant elevation of serum sCD30 was found to be associated with allograft rejection (X2⫽ 8.1, p⬍0.005). Only 5 patients had rejection episodes without elevation of serum sCD30. Thus it appears that, as previously reported for kidney transplants, in heart transplant recipients also, increased levels of sCD30 may be of interest to predict allograft rejection.
FACTORS AFFECTING sCD30 LEVELS AND ITS UTILITY IN POST-TRANSPLANT MONITORING Donna P. Lucas,1 Mary S. Leffell,1 Robert A. Montgomery,2 Christopher E. Simpkins,2 Andrea A. Zachary1, 1 Medicine, Johns Hopkins University, Baltimore, MD, USA; 2Surgery, Johns Hopkins University, Baltimore, MD, USA Serum levels of soluble (s) CD30, a receptor of the TNF family, released from activated T cells, are reported to predict outcome in renal transplantation. We investigated sCD30 levels in 5 groups: cardiac patients, sensitized and non-sensitized renal patients, patients undergoing desensitization for HLA or ABO incompatibility, and normal healthy males. Where possible, serum samples from several time pointswere examined: pre-treatment/transplant, at rejection, and at follow-up. We found that pre-transplant sCD30 levels in cardiac patients were not significantly different from those of normal controls (42.1 vs/ 20.6. P⫽0.10). However, all other comparisons of initial samples were significantly different. Following renal transplantation, sCD30 levels dropped significantly. Plasmapheresis did not reduce sCD30 further among sensitized patients (60.0) but did among unsensitized patients treated for ABO incompatibility (36.0, P⫽0.02). Sensitized patients had significantly higher pre-treatment levels than did nonsensitized patients (147.1 vs 97.8, P⫽0.001). sCD30 levels were increased during rejection and were greatest in patients experiencing cell-mediated (106.6) vs. antibody-mediated (61.2) rejection vs. rejection-free patients (49.0). In conclusion, we found that:  sCD30 levels are significantly higher in renal patients than in cardiac patients or normal controls;  immunosuppression reduces sCD30 levels significantly;  sCD30 levels are higher in sensitized vs. nonsensitized patients; and  sCD30 levels are increased during rejection. These results confirm that changes in serum CD30 levels correlate with inflammatory events such as rejection.