Abstract
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. 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. 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. We conclude that a pattern of persistently Not-TX GEP assay correlates with inferior graft survival.
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