title: Association of donor-specific microchimerism with graft dysfunction in kidney transplant patients.
abstract: The biological significance of donor-specific microchimerism (DSM) in solid organ transplantation is unresolved. It has been reported both as a favourable feature, which may facilitate induction and maintenance of tolerance, and as a sign of graft-vs-host disease. Here, we applied a quantitative real-time PCR assay (qRT-PCR) to a selected series of kidney transplant recipients to measure the level of microchimerism in relation to allograft function and survival. DSM level was assessed by scoring the HLA-DRB1 locus in 54 patients (42 males, 12 females) with more than 2 years of follow-up after transplantation; 38 patients were considered to have stable renal function (SRF) and 16 had allograft dysfunction (AD). Among patients with AD, 12 (75%) showed detectable level of microchimerism, compared to 11 (29%) SRF patients (Odds Ratio 7.36, 95% CI 1.7-35.2; p<0.01). In addition, AD patients showed a higher mean donor genome equivalents (6.5×10(-5) vs. 2.4×10(-5); p<0.001). SRF patients were re-evaluated two years later; 2 out of 27 DSM negative vs. 2 out of 11 DSM positive had lost their transplanted organ. In conclusion, qRT-PCR applied to peripheral blood shows significant association between DSM and allograft dysfunction in kidney transplant patients.
authors: Immunohematology Unit, Cisanello Hospital, Pisa, Italy. m.curcio@ao-pisa.toscana.it
authors: Michele
authors: M
authors: Curcio
authors: Diego
authors: D
authors: Cantarovich
authors: Serena
authors: S
authors: Barbuti
authors: Ugo
authors: U
authors: Boggi
authors: Silvia
authors: S
authors: Chelazzi
authors: Daniele
authors: D
authors: Focosi
authors: Simone
authors: S
authors: Lapi
authors: Gabriella
authors: G
authors: Paleologo
authors: Gaetano
authors: G
authors: Rizzo
authors: Fabrizio
authors: F
authors: Scatena
authors: Fabio
authors: F
authors: Vistoli
authors: Orazio
authors: O
authors: Vittorio
authors: Silvano
authors: S
authors: Presciuttini
authors: Franco
authors: F
authors: Mosca
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D055031:Primary Graft Dysfunction / Q000097:blood*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D018183:Transplantation Chimera / Q000097:blood*