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Updated: Aug 3, 2025
Using a Chemical Biopsy for Graft Quality Assessment
Published on: June 17, 2020
Multiple abnormal peripheral blood gene expression assay results are correlated with subsequent graft loss after
Raymond L Heilman1, James N Fleming2, Martin Mai3
1Department of Medicine, Mayo Clinic, Phoenix, Arizona, USA.
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.
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