title: MicroRNA-21 (miR-21) expression in hypothermic machine perfusate may be predictive of early outcomes in kidney transplantation.
abstract: Hypothermic machine perfusion is effective in improving outcome following kidney transplantation. Molecular analyses of hypothermic machine perfusate (HMP) have the potential to identify biomarkers of organ viability prior to transplantation, offering significant advantages to the transplant surgeon, and leading to a potential increase in the organ donor pool. MicroRNAs are emerging as important biomarkers in the context of kidney injury and transplantation. Recent data demonstrate increased microRNA-21 (miR-21) expression in the kidney following acute kidney injury. This study investigated the potential of miR-21 detected in HMP to act as a sentinel for early kidney transplant outcomes. MiR-21 was found to be readily detectable in HMP by RT-qPCR. Eleven ECD kidneys were maintained on a hypothermic machine perfusion system for a median 627 (range 117-1027) minutes, and evaluation of flow and resistance characteristics suggested stability on the machine from 60 min post-perfusion. MiR-21 quantification at 60 min post-perfusion correlated with eGFR at 6 and 12 months post-transplantation. These data suggest that miR-21 expression in HMP may be predictive of early outcomes following kidney transplantation. In the era of ECD kidneys, a reliable measure of organ quality is urgently needed, and this study suggests miR-21 may be such a marker.
authors.affiliation: Cardiff Transplant Unit, Department of Nephrology & Transplant Surgery, University Hospital of Wales, Cardiff, UK.|Department of Nephrology, School of Biological and Life Sciences, Cardiff University, Cardiff, UK.
authors.forename: Usman
authors.initials: U
authors.lastname: Khalid
authors.affiliation: Cardiff Transplant Unit, Department of Nephrology & Transplant Surgery, University Hospital of Wales, Cardiff, UK.
authors.forename: Elijah
authors.initials: E
authors.lastname: Ablorsu
authors.affiliation: Cardiff Transplant Unit, Department of Nephrology & Transplant Surgery, University Hospital of Wales, Cardiff, UK.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Szabo
authors.affiliation: Department of Nephrology, School of Biological and Life Sciences, Cardiff University, Cardiff, UK.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Jenkins
authors.affiliation: Department of Nephrology, School of Biological and Life Sciences, Cardiff University, Cardiff, UK.
authors.forename: Timothy
authors.initials: T
authors.lastname: Bowen
authors.affiliation: Cardiff Transplant Unit, Department of Nephrology & Transplant Surgery, University Hospital of Wales, Cardiff, UK.|Department of Nephrology, School of Biological and Life Sciences, Cardiff University, Cardiff, UK.
authors.forename: Rafael
authors.initials: R
authors.lastname: Chavez
authors.affiliation: Department of Nephrology, School of Biological and Life Sciences, Cardiff University, Cardiff, UK.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Fraser
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics*; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D007036:Hypothermia, Induced / Q000295:instrumentation* / Q000379:methods; D007668:Kidney / Q000502:physiology*; D016030:Kidney Transplantation; D008297:Male; D035683:MicroRNAs / Q000235:genetics*; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D010477:Perfusion / Q000295:instrumentation / Q000379:methods; D011379:Prognosis; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D015415:Biomarkers; C524940:MIRN21 microRNA, human; D035683:MicroRNAs
keywords: MicroRNA-21; biomarker; extended criteria donor; hypothermic machine perfusion; organ quality