Donor-derived circulating endothelial cells after kidney transplantation

Area of Science:

• Transplantation immunology
• Vascular biology
• Cellular diagnostics

Background:

• Solid-organ transplantation involves risks of allograft vasculature injury from various factors.
• Circulating endothelial cells (cEC) in kidney transplant recipients are linked to acute rejection and cytomegalovirus infections.
• The origin of cEC in kidney allograft recipients was previously unknown.

Purpose of the Study:

• To determine if circulating endothelial cells (cEC) in kidney transplant recipients originate from the donor.
• To investigate if cEC reflect damage to the allograft endothelium after kidney transplantation.

Main Methods:

• Isolation of 153 single circulating endothelial cells (cEC) from nine kidney allograft recipients.
• Determination of cEC origin (donor vs. recipient) using HLA-DRB allele typing.
• Application of single-cell, genomic, nested polymerase chain reaction for HLA typing.

Main Results:

• The majority of cEC (71.8%) were of donor origin.
• Donor-type cEC were detectable up to 141 days post-acute rejection.
• Recipient-type cEC (28.2%) were also detected, mirroring donor-type cEC presence.

Conclusions:

• Post-transplant injury to the allograft endothelium is indicated by the presence of donor-derived cEC.
• Donor-derived cEC serve as a biomarker for endothelial damage in kidney allografts.
• The findings support the hypothesis that cEC reflect transplantation-related endothelial injury.