Screening for serum N-glycan marker associated with early antibody-mediated rejection in patients receiving a living donor kidney transplant

Abstract

【Objectives】The aim of this study was to evaluate the use of serum N-glycan profiles for antibody mediated rejection (AMBR) prediction in living donor kidney transplant (LKTx).【Methods】Between 2007 and 2016, we retrospectively examined serum N-glycans associated with ABMR in 197 LKTx recipients of whom 16 recipients with ABMR with or without T cell mediated rejection (TCMR), 40 recipients with TCMR, and 141 recipients without any adverse events. Serum N-glycans were purified by glycoblotting method and quantified by mass spectrometry using serum samples on postoperative day 1 (POD1). Discriminant analysis for prediction of ABMR was performed by inputting ABMR event as explanatory variable, 36 kind of N-glycan concentration, recipient gender and age as objective variables. N-glycan score was calculated by ABMR predictive formula by using function of objective variables that obtained by discriminant analysis. ABMR predictive performance of N-glycan score assessed by receiveroperator characteristic curve (ROC) and Kaplan-Meier curves.【Results】The AUC for N-glycan score was 0.8916 much superior than DSA status (0.7619). Positive predictive value and negative predictive value of N-glycan score was 81.25％ and 86.74％, respectively. Kaplan-Meier curves analysis also showed that recipients with N-glycan score positive (＞0.8770) was significantly shorter non-ABMR survival than that of recipient with N-glycan score negative group.【Conclusions】Although, the limitations of our study included its small sample size, retrospective nature, the serum N-glycan score status may contribute for ABMR prediction.