Evaluation of serum tumor necrosis factor alpha and its correlation with histology in chronic kidney disease, stable renal transplant and rejection cases

Tumor necrosis factor alpha (TNF ?) is a cytokine secreted by macrophages, helper T cells, Natural Killer cells, B lymphocytes and non lymphoid cells e.g. endothelial cells, fibroblast and tumor cell lines. Aim of the study was to find the utility of TNF ? in diagnosing renal transplant rejection among the renal transplant cases (n=29), and comparison with the levels in patients on maintenance hemodialysis (n=21) and healthy controls (n=20). TNF ? in healthy controls varied from 2 to 15 pg/mL. In chronic renal failure and renal transplant rejection cases TNF ? was above 45 pg/mL. In stable renal transplant patients it was higher than normal (16 to 30 pg/mL). In both acute and chronic transplant rejection TNF ? increase correlated well with histology. Thus our study suggests that TNF a level more than 45 pg/mL can be taken as an immunological marker of renal transplant rejection.