B Cell Activating Factor (BAFF) As A Novel Alert Marker for The Immunological Risk Stratification After Kidney Transplantation: A Prospective Controlled Study

Background: Kidney allograft failure is an essential issue in renal diseases and participates in the increasing number of subjects with end-stage kidney disease (ESKD). Rejection episodes remain impactful occasions after kidney transplant, in spite of the use of potent immunosuppressive agents. B-cell activating factor (BAFF) is essential for appropriate immune response mediated by B cells.
Patients and Methods: This concurrent prospective controlled cohort study included 120 patients classified into 2 groups, study group who experienced graft rejection during the study duration (n=20) and control group who did not develop graft rejection during the same study duration (n=100). Human Baf/BlyS/TNFSF13 B immunoassay was used to assess BAFF level in the serum. Patients were monitored for graft function, graft survival, episodes of graft rejection and other possible complications following kidney transplantation during the study duration and the follow-up period.
Results: Males were over-represented among recipients with rejection (p=0.0345), the distribution of HLA-A and B mismatches (0–4) did not differ significantly (p=0.1). For HLA-DR, 0 vs 1 mismatch showed insignificant difference (p=0.118), though the direction favored more 0-mismatch among controls. BAFF concentrations were higher in patients with rejection (3.79±1.58) compared with controls (2.61±0.78), with a statistically significant difference (p=0.003).
Conclusion: BAFF shows promise as a practical, non-invasive biomarker to enhance immunologic risk stratification and personalize post-transplant surveillance; rigorous validation and integration with molecular diagnostics are warranted before routine adoption.