Abstract: TH-PO0957
Elevated Soluble Urokinase Plasminogen Activator Receptor Levels Correlate with Allograft Injury and Decline in Renal Function During Kidney Transplant Rejection
Session Information
- Transplantation: Clinical - Glomerular Diseases, Infections, and Rejection
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Cicalese, Luca, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
- Rastellini, Cristiana, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
- Nguyen, Philong, The University of Texas Medical Branch John Sealy School of Medicine, Galveston, Texas, United States
- Papalardo, Elizabeth, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
- Wang, Qingrong, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
- Li, Jing, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
- Wei, David Changli, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
- Reiser, Jochen, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
Background
Soluble urokinase-type plasminogen activator receptor (suPAR) is a risk factor for kidney disease and a biomarker of innate immune activation. In the context of kidney transplantation, the early detection of rejection is critical to preserving graft function. We investigated the relationship between suPAR levels, serum creatinine, and estimated glomerular filtration rate (eGFR) in kidney transplant recipients experiencing acute cellular rejection (ACR), antibody-mediated rejection (AMR), or both.
Methods
We performed a retrospective analysis of 14 transplant patients with biopsy-proven rejection (ACR, AMR, or ACR+AMR). For each patient, we collected suPAR, creatinine, and eGFR values at four standardized time points: 6 months prior to rejection, 3 months prior to rejection, during the rejection episode, and 3- and 6-months post-rejection. Pearson correlation analyses were conducted to assess the strength of association between suPAR and both kidney injury (creatinine) and function (eGFR).
Results
This preliminary analysis showed that suPAR levels increased progressively leading up to and during rejection, then declined post-treatment. suPAR demonstrated a strong positive correlation with creatinine (r=+0.82) and a strong inverse correlation with eGFR (r=–0.81), suggesting a robust association with allograft injury and dysfunction. In this analysis, creatinine and eGFR exhibited a near-perfect inverse relationship (r=–1.00, p=0.0005), data is shown in figure. suPAR trends consistently paralleled clinical rejection episodes and kidney performance, even preceding overt clinical or laboratory deterioration in some cases.
Conclusion
suPAR levels rise in the setting of acute rejection and track closely with renal dysfunction. These findings suggest suPAR may serve as an early, non-invasive biomarker to monitor immune-mediated kidney injury. Incorporating suPAR measurement into transplant surveillance could improve timely detection and intervention, ultimately enhancing long-term graft survival.
SuPAR with Renal Function Markers: Creatinine and eGFR