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Observational Study
. 2023 Aug;37(8):e14987.
doi: 10.1111/ctr.14987. Epub 2023 Apr 7.

Multiple abnormal peripheral blood gene expression assay results are correlated with subsequent graft loss after kidney transplantation

Raymond L Heilman  1 , James N Fleming  2 , Martin Mai  3 , Byron Smith  4 , Walter D Park  5 , John Holman  6 , Mark D Stegall  5
Affiliations
Observational Study

Multiple abnormal peripheral blood gene expression assay results are correlated with subsequent graft loss after kidney transplantation

Raymond L Heilman et al. Clin Transplant. 2023 Aug.

Abstract

Background: The aim of this study was to correlate peripheral blood gene expression profile (GEP) results during the first post-transplant year with outcomes after kidney transplantation.

Methods: We conducted a prospective, multicenter observational study of obtaining peripheral blood at five timepoints during the first post-transplant year to perform a GEP assay. The cohort was stratified based on the pattern of the peripheral blood GEP results: Tx-all GEP results normal, 1 Not-TX had one GEP result abnormal and >1 Not-TX two or more abnormal GEP results. We correlated the GEP results with outcomes after transplantation.

Results: We enrolled 240 kidney transplant recipients. The cohort was stratified into the three groups: TX n = 117 (47%), 1 Not-TX n = 59 (25%) and >1 Not-TX n = 64 (27%). Compared to the TX group, the >1 Not-TX group had lower eGFR (p < .001) and more chronic changes on 1-year surveillance biopsy (p = .007). Death censored graft survival showed inferior graft survival in the >1 Not-TX group (p < .001) but not in the 1 Not-TX group. All graft losses in the >1 Not-TX group occurred after 1-year post-transplant.

Conclusions: We conclude that a pattern of persistently Not-TX GEP assay correlates with inferior graft survival.

Keywords: graft survival; kidney transplant outcomes; peripheral blood gene expression.

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References

REFERENCES

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