Exome Sequencing and Prediction of Long-Term Kidney Allograft Function.
Current strategies to improve graft outcome following kidney transplantation consider information at the human leukocyte antigen (HLA) loci. Cell surface antigens, in addition to HLA, may serve as the stimuli as well as the targets for the anti-allograft immune response and influence long-term graft outcomes. We therefore performed exome sequencing of DNA from kidney graft recipients and their living donors and estimated all possible cell surface antigens mismatches for a given donor/recipient pair by computing the number of amino acid mismatches in trans-membrane proteins. We designated this tally as the allogenomics mismatch score (AMS). We examined the association between the AMS and post-transplant estimated glomerular filtration rate (eGFR) using mixed models, considering transplants from three independent cohorts (a total of 53 donor-recipient pairs, 106 exomes, and 239 eGFR measurements). We found that the AMS has a significant effect on eGFR (mixed model, effect size across the entire range of the score: -19.4 [-37.7, -1.1], P = 0.0042, χ2 = 8.1919, d.f. = 1) that is independent of the HLA-A, B, DR matching, donor age, and time post-transplantation. The AMS effect is consistent across the three independent cohorts studied and similar to the strong effect size of donor age. Taken together, these results show that the AMS, a novel tool to quantify amino acid mismatches in trans-membrane proteins in individual donor/recipient pair, is a strong, robust predictor of long-term graft function in kidney transplant recipients.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, United States of America; Department of Physiology and Biophysics, The Weill Cornell Medical College, New York, New York, United States of America.|INSERM UMR1155 et Service des Urgences Néphrologiques et Transplantation Rénale, APHP, Hôpital Tenon, Paris, France.|Sorbonne Universités, UPMC Université Paris 06, Paris, France.
Laurent
L
Mesnard
Division of Nephrology and Hypertension, Weill Cornell Medical College, New York, New York, United States of America.|Department of Transplantation Medicine, New York Presbyterian Hospital, New York, New York, United States of America.
Thangamani
T
Muthukumar
Division of Nephrology and Hypertension, Weill Cornell Medical College, New York, New York, United States of America.
Maren
M
Burbach
Division of Nephrology and Hypertension, Weill Cornell Medical College, New York, New York, United States of America.
Carol
C
Li
Genomics Core Facility, Weill Cornell Medical College, New York, New York, United States of America.
Huimin
H
Shang
Division of Nephrology and Hypertension, Weill Cornell Medical College, New York, New York, United States of America.|Department of Transplantation Medicine, New York Presbyterian Hospital, New York, New York, United States of America.
Darshana
D
Dadhania
Division of Nephrology and Hypertension, Weill Cornell Medical College, New York, New York, United States of America.|Department of Transplantation Medicine, New York Presbyterian Hospital, New York, New York, United States of America.
John R
JR
Lee
Division of Nephrology and Hypertension, Weill Cornell Medical College, New York, New York, United States of America.
Vijay K
http://orcid.org/0000-0003-4016-9911
VK
Sharma
Genomics Core Facility, Weill Cornell Medical College, New York, New York, United States of America.
Jenny
J
Xiang
Laboratoire d'histocompatibilité Hôpital Saint Louis APHP, Paris, France.
Caroline
C
Suberbielle
Laboratoire d'histocompatibilité Hôpital Saint Louis APHP, Paris, France.
Maryvonnick
M
Carmagnat
INSERM UMR1155 et Service des Urgences Néphrologiques et Transplantation Rénale, APHP, Hôpital Tenon, Paris, France.
Nacera
N
Ouali
INSERM UMR1155 et Service des Urgences Néphrologiques et Transplantation Rénale, APHP, Hôpital Tenon, Paris, France.|Sorbonne Universités, UPMC Université Paris 06, Paris, France.
Eric
E
Rondeau
Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America.
John J
http://orcid.org/0000-0002-9344-9928
JJ
Friedewald
Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America.
Michael M
MM
Abecassis
Division of Nephrology and Hypertension, Weill Cornell Medical College, New York, New York, United States of America.|Department of Transplantation Medicine, New York Presbyterian Hospital, New York, New York, United States of America.
Manikkam
M
Suthanthiran
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, United States of America; Department of Physiology and Biophysics, The Weill Cornell Medical College, New York, New York, United States of America.
Fabien
http://orcid.org/0000-0001-6237-3564
F
Campagne
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