Multiple abnormal peripheral blood gene expression assay results are correlated with subsequent graft loss after kidney transplantation

Raymond L. Heilman, James N. Fleming, Martin Mai, Byron Smith, Walter D. Park, John Holman, Mark D. Stegall

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The aim of this study was to correlate peripheral blood gene expression profile (GEP) results during the first post-transplant year with outcomes after kidney transplantation. Methods: We conducted a prospective, multicenter observational study of obtaining peripheral blood at five timepoints during the first post-transplant year to perform a GEP assay. The cohort was stratified based on the pattern of the peripheral blood GEP results: Tx-all GEP results normal, 1 Not-TX had one GEP result abnormal and >1 Not-TX two or more abnormal GEP results. We correlated the GEP results with outcomes after transplantation. Results: We enrolled 240 kidney transplant recipients. The cohort was stratified into the three groups: TX n = 117 (47%), 1 Not-TX n = 59 (25%) and >1 Not-TX n = 64 (27%). Compared to the TX group, the >1 Not-TX group had lower eGFR (p <.001) and more chronic changes on 1-year surveillance biopsy (p =.007). Death censored graft survival showed inferior graft survival in the >1 Not-TX group (p <.001) but not in the 1 Not-TX group. All graft losses in the >1 Not-TX group occurred after 1-year post-transplant. Conclusions: We conclude that a pattern of persistently Not-TX GEP assay correlates with inferior graft survival.

Original languageEnglish (US)
Article numbere14987
JournalClinical Transplantation
Volume37
Issue number8
DOIs
StatePublished - Aug 2023

Keywords

  • graft survival
  • kidney transplant outcomes
  • peripheral blood gene expression

ASJC Scopus subject areas

  • Transplantation

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