title: Effect of delayed graft function, acute rejection and chronic allograft dysfunction on kidney allograft telomere length in patients after transplantation: a prospective cohort study.
abstract: BACKGROUND
  The outcome of kidney allograft transplantation is associated with numerous donor-dependent and recipient-dependent immunological and non-immunological factors. Studies on genetic factors affecting the non-immunological aspects, like ageing of the kidney allograft and patient outcome are still lacking. The aim of this study was the analysis of relative telomere length (RTL; T/S ratio) in the biopsy specimens of the transplanted kidney allograft and its correlation with the delayed graft function (DGF), acute rejection (AR) and chronic allograft dysfunction (CAD).
  
  
  METHODS
  The study enrolled 119 Caucasian kidney allograft recipients (64 M/55 F, mean age 47.32 ± 14.03; transplantation performed between 2001 and 2012). Organs were harvested from cadaveric donors (59.8 M/40.2 F, mean age 45.99 ± 14.62).
  
  
  RESULTS
  There were significant differences in RTL assessed in kidney allograft biopsy specimens collected 3-6 months after transplantation between patients with DGF and without DGF (181.8 ± 82.0 vs. 284.6 ± 149.6; p < 0.05) and in RTL of kidney allograft biopsy specimens collected 18-60 months after transplantation between patients with AR and without AR (188.1 ± 162.1 vs. 263.3 ± 134.7; p = 0.047). There were significant differences in RTL assessed in kidney allograft biopsy specimens collected 12-24 months after transplantation between patients with CAD and without CAD (168.0 ± 120.0 vs. 282.1 ± 158.4; p = 0.038).
  
  
  CONCLUSIONS
  Duration of dialysis before transplantation and PRA influence the kidney allograft ageing. Telomere length assessed in biopsy specimens collected in the peri-transplant period predicts the long-term kidney allograft function. Complications of kidney transplantation, like DGF, AR and CAD are linked with the telomere length and thus, graft ageing.
authors.affiliation: Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University in Szczecin, Ul. Powstancow Wlkp. 72, 70-111, Szczecin, Poland. box1a@interia.pl.
authors.forename: Leszek
authors.initials: L
authors.lastname: Domański
authors.affiliation: Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University in Szczecin, Ul. Powstancow Wlkp. 72, 70-111, Szczecin, Poland. wikarla@gazeta.pl.
authors.forename: Karolina
authors.initials: K
authors.lastname: Kłoda
authors.affiliation: Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University in Szczecin, Ul. Powstancow Wlkp. 72, 70-111, Szczecin, Poland. ewakwiat@gmail.com.
authors.forename: Ewa
authors.initials: E
authors.lastname: Kwiatkowska
authors.affiliation: Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University in Szczecin, Ul. Powstancow Wlkp. 72, 70-111, Szczecin, Poland. eborowiecka@poczta.fm.
authors.forename: Ewa
authors.initials: E
authors.lastname: Borowiecka
authors.affiliation: Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland. chrissaf@mp.pl.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Safranow
authors.affiliation: Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, Szczecin, Poland. arleta.drozd@gmail.com.
authors.forename: Arleta
authors.initials: A
authors.lastname: Drozd
authors.affiliation: Department of Laboratory Diagnostics and Molecular Medicine, Szczecin, Poland. aciech@pum.edu.pl.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Ciechanowicz
authors.affiliation: Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University in Szczecin, Ul. Powstancow Wlkp. 72, 70-111, Szczecin, Poland. kazcie@sci.pum.edu.pl.
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Ciechanowski
mesh_terms: D000208:Acute Disease; D000328:Adult; D064591:Allografts / Q000378:metabolism / Q000473:pathology; D002102:Cadaver; D016922:Cellular Senescence / Q000235:genetics*; D002908:Chronic Disease; D015331:Cohort Studies; D051799:Delayed Graft Function / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006084:Graft Rejection / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000378:metabolism* / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D055031:Primary Graft Dysfunction / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D011446:Prospective Studies; D006435:Renal Dialysis; D016615:Telomere / Q000378:metabolism*; D059506:Telomere Shortening / Q000235:genetics*; D013997:Time Factors