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35.8.3. Renal transplantation

Chapter 35

Three preliminary reports have been published concerning FLCs in renal transplant recipients. Li et al. [819] found that, out of a number of urinary proteins measured, FLCs provided the best prediction of early allograft rejection (n=103). Shabir et al. [820] measured serum ΣFLCs in two transplant cohorts (n=399 and n=40) and found variations according to the type and level of immunosuppression. It was speculated that sFLC measurement might provide information useful for managing immunosuppressive regimes. Shabir et al. [821] quantified ΣFLCs in serial serum samples collected from 79 renal transplant recipients and corrected values for renal function to give a better estimate of FLC production (eFLC). eFLC was lower when more aggressive immunosuppression was being administered and low levels were predictive of increased risk of infection.

References

    • 1. Li M, Chouhan KK, Gullo KE, Simon EE, Zhang R, Batuman V. Urinary free light chains predict acute rejection in patients with a kidney transplant. Presented at World Congress of Nephrology 2011;SU531a
    • 2. Shabir S, Bevins A, Cockwell P, Borrow R, Hutchison CA. Polyclonal immunoglobulin free light chains provide a novel insight into immunosuppressant use in renal transplant recipients. J Am Soc Nephrol 2011;22:TH-PO1007a
    • 3. Shabir S, Bevins A, Church HL, Borrows R, Hutchison C. Production rates of free light chains predict infections post-transplant. Nephrology 2012;17:47-75