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Peer-reviewedCC BY 4.0Transplant International

Urinary CXCL10 for detection of rejection and infection at 1-year posttransplant

  • Alain M. Häseli1
  • Karoline Leuzinger2
  • Matthias Diebold1
  • Caroline Wehmeier1
  • Joëlle Handschin1,3
  • Patrizia Amico1
  • Michael Dickenmann1
  • Pietro E. Cippà1
  • Helmut Hopfer4
  • Patricia Hirt-Minkowski1
  • Stefan Schaub1,3
4 affiliations
  1. 1Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland
  2. 2Clinical Virology, University Hospital Basel, Basel, Switzerland
  3. 3HLA-Diagnostics and Immunogenetics, Department of Laboratory Medicine, University Hospital Basel, Basel, Switzerland
  4. 4Institute of Pathology, University of Basel, Basel, Switzerland
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Abstract

Urinary CXCL10 chemokine levels correlate with inflammatory processes in the reno-urinary tract after kidney transplantation. The aim of this study was to investigate the diagnostic characteristics of urinary CXCL10/creatinine ratio to detect major inflammatory processes (i.e., subclinical rejection, relevant JC/BK polyomavirus DNAuria, or significant leukocyturia) in 405 stable renal allograft recipients with surveillance biopsies at 1 year posttransplant. Urinary CXCL10/creatinine had a significantly higher area under the curve (AUC) than serum creatinine or proteinuria (0.786 vs. 0.499 vs. 0.636; both p < 0.0001) for detection of inflammatory processes. The highest AUC was observed for the detection of BK polyomavirus DNAuria (0.936), but it was lower for detection of subclinical rejection (0.703). At an arbitrary rule-out cutoff (CXCL10/creatinine <3 ng/mmol; 59% of all patients; negative likelihood ratio 0.36), 51% of surveillance biopsies could be safely deferred, and the risk of subclinical rejection decreased from 15.8% to 5.4%. At an arbitrary rule-in cutoff (CXCL10/creatinine >10 ng/mmol; 12% of all patients; positive likelihood ratio 12.92), absence of any inflammatory pathologies was only 2%. These data support urinary CXCL10/creatinine measurements at 1-year posttransplant in stable allografts to detect inflammatory processes and guide further diagnostics. The preliminary cutoffs require external validation.

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Cite

BibTeXRIS
BibTeX
@article{haseli2026urinary,
  title = {{Urinary CXCL10 for detection of rejection and infection at 1-year posttransplant}},
  author = {Alain M. Häseli and Karoline Leuzinger and Matthias Diebold and Caroline Wehmeier and Joëlle Handschin and Patrizia Amico and Michael Dickenmann and Pietro E. Cippà and Helmut Hopfer and Patricia Hirt-Minkowski and Stefan Schaub},
  journal = {Transplant International},
  year = {2026},
  month = oct,
  doi = {10.3389/ti.2026.17130},
  url = {https://doi.org/10.3389/ti.2026.17130},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Urinary CXCL10 for detection of rejection and infection at 1-year posttransplant
AU  - Alain M. Häseli
AU  - Karoline Leuzinger
AU  - Matthias Diebold
AU  - Caroline Wehmeier
AU  - Joëlle Handschin
AU  - Patrizia Amico
AU  - Michael Dickenmann
AU  - Pietro E. Cippà
AU  - Helmut Hopfer
AU  - Patricia Hirt-Minkowski
AU  - Stefan Schaub
PY  - 2026
DA  - 2026/10/12
JO  - Transplant International
DO  - 10.3389/ti.2026.17130
UR  - https://doi.org/10.3389/ti.2026.17130
AB  - Urinary CXCL10 chemokine levels correlate with inflammatory processes in the reno-urinary tract after kidney transplantation. The aim of this study was to investigate the diagnostic characteristics of urinary CXCL10/creatinine ratio to detect major inflammatory processes (i.e., subclinical rejection, relevant JC/BK polyomavirus DNAuria, or significant leukocyturia) in 405 stable renal allograft recipients with surveillance biopsies at 1 year posttransplant. Urinary CXCL10/creatinine had a significantly higher area under the curve (AUC) than serum creatinine or proteinuria (0.786 vs. 0.499 vs. 0.636; both p < 0.0001) for detection of inflammatory processes. The highest AUC was observed for the detection of BK polyomavirus DNAuria (0.936), but it was lower for detection of subclinical rejection (0.703). At an arbitrary rule-out cutoff (CXCL10/creatinine <3 ng/mmol; 59% of all patients; negative likelihood ratio 0.36), 51% of surveillance biopsies could be safely deferred, and the risk of subclinical rejection decreased from 15.8% to 5.4%. At an arbitrary rule-in cutoff (CXCL10/creatinine >10 ng/mmol; 12% of all patients; positive likelihood ratio 12.92), absence of any inflammatory pathologies was only 2%. These data support urinary CXCL10/creatinine measurements at 1-year posttransplant in stable allografts to detect inflammatory processes and guide further diagnostics. The preliminary cutoffs require external validation.
SN  - 0934-0874
SN  - 1432-2277
ER  -