Evaluation of Calprotectin Level in Intestinal Content as an Early Marker for Graft Rejection

Cagnola, H.; Scaravonati, Rodolfo; Cabanne, Ana; Bianchi, Carolina; Gruz, Fernando; Errea, Agustina Juliana; Zambernardi, Agustina; Meier, Dominik; Chirdo, Fernando Gabriel; Docena, Guillermo Horacio; Gondolesi, Gabriel; Rumbo, Martı́n

doi:10.1016/j.transproceed.2009.12.013

Cited by 19 publications

(10 citation statements)

References 14 publications

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“…Although several molecules have been suggested as biomarkers of rejection (e.g. calprotectin, citrulline, granzymeB and perforin), they generally lack sufficient sensitivity and specificity to be widely applicable (3,32–37). The results obtained during this study suggest that microbial profiling may be a potential diagnostic marker for graft rejection that could be used in conjunction with existing diagnostic tools to monitor SBT.…”

Section: Discussionmentioning

confidence: 99%

Characterization of the Ileal Microbiota in Rejecting and Nonrejecting Recipients of Small Bowel Transplants

Martínez

Sun

et al. 2012

American Journal of Transplantation

137

100

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†Authors contributed equally to this work.Small bowel transplantation can be a life-preserving procedure for patients with irreversible intestinal failure. Allograft rejection remains a major source of morbidity and mortality and its accurate diagnosis and treatment are critical. In this study, we used pyrosequencing of 16S ribosomal RNA gene tags to compare the composition of the ileal microbiota present during nonrejection, prerejection and active rejection states in small bowel transplant patients. During episodes of rejection, the proportions of phylum Firmicutes (p < 0.001) and the order Lactobacillales (p < 0.01) were significantly decreased, while those of the phylum Proteobacteria, especially the family Enterobacteriaceae, were significantly increased (p < 0.005). Receiveroperating characteristic analysis revealed that relative proportions of several bacterial taxa in ileal effluents and especially Firmicutes, could be used to discriminate between nonrejection and active rejection. In conclusion, the findings obtained during this study suggest that small bowel transplant rejection is associated with changes in the microbial populations in ileal effluents and support microbiota profiling as a potential diagnostic biomarker of rejection. Future studies should investigate if the dysbiosis that we observed is a cause or a consequence of the rejection process.

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Section: Discussionmentioning

confidence: 99%

Characterization of the Ileal Microbiota in Rejecting and Nonrejecting Recipients of Small Bowel Transplants

Martínez

Sun

et al. 2012

American Journal of Transplantation

137

100

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“…Calprotectin levels could not distinguish between any pathologic states, however. Another study of 137 samples from 11 patients [23] found no significant difference between normal and rejection, in part because of wide variability, and suggested a cutoff of 65 mg/g stool had a sensitivity of 76% and specificity of 47% to detect rejection. They concluded that stool calprotectin was perhaps not a unique marker for rejection, but rather a marker of normality and stability.…”

Section: Calprotectinmentioning

confidence: 99%

Hot topics in postsmall bowel transplantation: noninvasive graft monitoring including stool calprotectin and plasma citrulline

Mercer¹

2011

Current Opinion in Organ Transplantation

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“…Other biomarkers employed in this case also failed to convincingly point towards a diagnosis of rejection. Fluctuations in the levels of biomarkers such as faecal calprotectin and plasma citrulline implied underlying graft rejection, but their validity in reliably identifying underlying pathoaetiology is contested [ 17 , 18 ]. Additionally, in the absence of clear microscopic and macroscopic evidence of rejection, the presence of Class I anti-HLA-B37 antibodies alone does not strongly point towards a diagnosis of rejection.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Lessons from a Complex Case of Postintestinal Transplantation Enteropathy

Wade

Allan

Collantes

et al. 2017

Case Reports in Transplantation

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Recent advances in the field of intestinal transplantation have been mitigated by the incidence of allograft rejection. In such events, early identification and appropriate timing of antirejection therapy are crucial in retaining graft function. We present the case of a patient who suffered severe postintestinal transplantation allograft enteropathy, primarily characterized by extensive mucosal ulcerations, and was refractory to all conventional therapy. This progressed as chronic rejection; however crucially this was not definitively diagnosed until allograft function had irreversibly diminished. We argue that the difficulties encountered in this case can be attributed to the inability of our current array of investigative studies and diagnostic guidelines to provide adequate clinical guidance. This case illustrates the importance of developing reliable and specific markers for guiding the diagnosis of rejection and the use of antirejection therapeutics in this rapidly evolving field of transplant surgery.

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Evaluation of Calprotectin Level in Intestinal Content as an Early Marker for Graft Rejection

Cited by 19 publications

References 14 publications

Characterization of the Ileal Microbiota in Rejecting and Nonrejecting Recipients of Small Bowel Transplants

Characterization of the Ileal Microbiota in Rejecting and Nonrejecting Recipients of Small Bowel Transplants

Hot topics in postsmall bowel transplantation: noninvasive graft monitoring including stool calprotectin and plasma citrulline

Diagnostic Lessons from a Complex Case of Postintestinal Transplantation Enteropathy

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