Gene expression profiling of the donor kidney at the time of transplantation predicts clinical outcomes 2 years after transplantation.
We have previously demonstrated that biomarkers of inflammation and immune activity detected within intraoperative renal transplant allograft biopsies are linked to adverse short-term post-transplantation clinical outcomes. Now we provide a post hoc analysis of our earlier data in the light of longer clinical follow-up. A total of 75 consecutively performed renal allografts were analyzed for gene expression of proinflammatory molecules, inflammation-induced adhesion molecules, and antiapoptotic genes expressed 15 minutes after vascular reperfusion to determine whether this analysis can aid in predicting long-term quality of renal function, proteinuria, graft loss, and death-censored graft. We have built predictive models for proteinuria (area under the curve = 0.859, p = 0.0001) and graft loss (area under the curve = 0.724, p = 0.027) 2 years post-transplantation using clinical variables in combination with intragraft gene expression data of tumor necrosis factor-alpha, interleukin-6, CD40, CD3, and tumor necrosis factor-alpha, Bcl-2, and interferon-gamma, respectively. This post hoc analysis demonstrates that hypothesis-driven, targeted polymerase chain reaction profiling of gene expression in the donor kidney at the time of engraftment can predict 2-year post-transplantation clinical outcomes.
Transplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Gabor
G
Bodonyi-Kovacs
Prabhakar
P
Putheti
Miguel
M
Marino
Yingyos
Y
Avihingsanon
Marc E
ME
Uknis
Anthony P
AP
Monaco
Terry B
TB
Strom
Martha
M
Pavlakis
D019540:Area Under Curve; D015415:Biomarkers / Q000032:analysis*; D020869:Gene Expression Profiling; D006084:Graft Rejection / Q000235:genetics / Q000276:immunology; D006085:Graft Survival / Q000235:genetics* / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D016133:Polymerase Chain Reaction; D012372:ROC Curve; D014019:Tissue Donors; D016896:Treatment Outcome
D015415:Biomarkers