Urinary Basigin/CD147 Is a Useful Marker of Acute T Cell-Mediated Rejection in Kidney Transplant Recipients

Background: Acute T cell-mediated rejection (ATCMR) is one of the severe problems following kidney transplantation. However, no reliable marker of it is currently available in Japan. Methods: This cross-sectional study was performed at Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital to determine whether serum or urinary Basigin/CD147 worked as an effective marker of ATCMR from 2016 to 2018. Serum and urinary samples were obtained when episode graft biopsies were done. Results: A total of 46 kidney transplant recipients received graft biopsies. Three of them missed serum and urinary samples and three in ATCMR were on post-rejection treatment. Graft biopsy results revealed ATCMR in 12 of them, calcineurin inhibitor nephrotoxicity (CNIN) in 9, chronic active antibody-mediated rejection (CAAMR) in 9, BK nephropathy, recurrence IgA nephropathy, necrotic glomerulonephritis, and infection-related glomerulonephritis in one each, and others in 6. Urinary Basigin/CD147 levels in patients with ATCMR group (690.1 ± 247.0 pg/gCre) were notably greater than those in patients with CAAMR (242.2 ± 86.1 pg/ gCre) and CNIN groups (351.6 ± 117.0 pg/ gCre). (P < 0.001)(Figure1) No statistical difference in serum Basigin/CD147 levels was observed between those groups. At an urinary Basigin/CD147 of 631.5 pg/gCre, sensitivity, and specificity of 75% and 84%, respectively, were reached for diagnosing acute rejection with an area under the curve of 0.80.(Figure2) Conclusion: Urinary Basigin/CD147 was correlated with tubulointerstitial damage and might be a potential marker for ATCMR in kidney transplant recipients. Further study will be needed to clarify the effectiveness of Basigin/CD147.