title: Identification of biomarkers to assess organ quality and predict posttransplantation outcomes.
abstract: The increased disparity between organ supply and need has led to the use of extended criteria donors and donation after cardiac death donors with other comorbidities.
  
  
  METHODS
  We have examined the preimplantation transcriptome of 112 kidney transplant recipient samples from 100 deceased-donor kidneys by microarray profiling. Subject groups were segregated based on estimated glomerular filtration rate (eGFR) at 1 month after transplantation: the GFR-high group (n=74) included patients with eGFR 45 mL/min per 1.73 m(2), whereas the GFR-low group (n=35) included patients with eGFR 45 mL/min or less per 1.73 m(2).
  
  
  RESULTS
  Gene expression profiling identified higher expression of 160 probe sets (140 genes) in the GFR-low group, whereas expression of 37 probe sets (33 genes) was higher in the GFR-high group (P<0.01, false discovery rate <0.2). Four genes (CCL5, CXCR4, ITGB2, and EGF) were selected based on fold change and P value and further validated using an independent set of samples. A random forest analysis identified three of these genes (CCL5, CXCR4, and ITGB2) as important predictors of graft function after transplantation.
  
  
  CONCLUSIONS
  Inclusion of pretransplantation molecular gene expression profiles in donor quality assessment systems may provide the necessary information for better donor organ selection and function prediction. These biomarkers would further allow a more objective and complete assessment of procured renal allografts at pretransplantation time.
authors.affiliation: Division of Transplantation, Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908-0679, USA.
authors.forename: Mariano J
authors.initials: MJ
authors.lastname: Scian
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Maluf
authors.forename: Kellie J
authors.initials: KJ
authors.lastname: Archer
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Turner
authors.forename: Jihee L
authors.initials: JL
authors.lastname: Suh
authors.forename: Krystle G
authors.initials: KG
authors.lastname: David
authors.forename: Anne L
authors.initials: AL
authors.lastname: King
authors.forename: Marc P
authors.initials: MP
authors.lastname: Posner
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Brayman
authors.forename: Valeria R
authors.initials: VR
authors.lastname: Mas
mesh_terms: D015415:Biomarkers; D005919:Glomerular Filtration Rate; D006801:Humans; D016030:Kidney Transplantation; D020411:Oligonucleotide Array Sequence Analysis; D016016:Proportional Hazards Models; D015398:Signal Transduction; D014019:Tissue Donors; D059467:Transcriptome; D014184:Transplantation, Homologous
chemical_list: D015415:Biomarkers