Increased levels of Gal beta 1-4GlcNAc alpha 2-6 sialyltransferase pretransplant predict delayed graft function kidney transplant recipients

Background. Gal beta 1-4GlcNAc alpha 2-6 sialyltransferase (ST6GalI) is an acute phase reactant whose release from cells can be induced by proinflamma tory cytokines, Because patients with chronic renal failure have high circu lating levels of proinflammatory cytokines, we hypothesized that patients o n the renal transplant waiting list would have high circulating levels of S T6GalI, which might adversely affect posttransplant events. Methods. Levels of ST6GalI were measured in the serum of 70 patients immedi ately before renal transplant; these were correlated with posttransplant ev ents, such as delayed graft function and rejection, Results, The mean serum level of ST6GalI was significantly higher in the pa tients (3162+/-97 U) than in 19 controls (2569 +/- 125 U; P < 0.003). Patie nts who required dialysis posttransplant for treatment of delayed graft fun ction (n=20) had significantly higher levels of ST6GalI pretransplant (3735 +/-228 U) than patients (n=50) who did not require dialysis (2933+/-83 U; P <0.0001), In a multivariate analysis the ST6GalI level and cold ischemic ti me were found to be independent risk factors for the development of delayed graft function, Conclusions, ST6GalI levels are high in renal failure patients awaiting a r enal transplant and may be a risk factor for the development of delayed gra ft function. The assessment and perhaps modulation of a potential transplan t recipient's ST6GalI systemic level may be beneficial.