Where: At the Research Institute of the McGill University Health Centre (RI‑MUHC) Glen Site, block E, room M1.3509, 1001 Decarie Boulevard, Montreal, Quebec H4A 3J1
When: Wednesday, March 27, 12–1 p.m.
Speaker: Jean Tchervenkov, MDCM, FRCS, FACS
Professor of Surgery
Director of Renal Transplantation
Hepatobiliary and Transplantation Surgery
McGill University Health Centre
Developing novel tools to predict allograft outcomes of renal transplantation with pretransplant donor-recipient metrics
Purpose: Early allograft dysfunction as well as long-term graft loss are major obstacles to successful kidney transplantation. There is a need to find new pretransplant biomarkers to predict the graft dysfunction that could be useful in making decisions for optimal allocation of donor kidneys. Earlier, pretransplant recipient circulating CD4+CD127lo/- TNFR2+ Treg cell has been shown as an immune marker for acute kidney injury (AKI). In this study we used donor and recipient metrics to predict graft outcomes after renal transplantation. Methods: In this study, 76 deceased donor kidney transplant recipients circulating CD4+CD127lo/-TNFR2+ Treg cells were measured by flow cytometry. The recipients and donor’s characteristics were retrieved from the database. Binary logistic regression was performed to assess the predictive accuracy of donor, recipient and organ quality variables for the early transplant outcomes as well as graft loss 8 years after kidney transplantation. Results: Variables like Kidney Donor Risk Index, cold ischemic time and sensitization were incorporated with pretransplant percent of CD4+CD127lo/- TNFR2+ Treg cells to create logistic regression models to predict delayed graft function (AUC=.801, p value<.01), AKI (AUC=.910, p value<.01), acute rejection in 6 months (AUC=.861, p value<.01), and graft loss after 8 years (AUC=.765, p value<.01). Conclusions: It is possible to predict short and long term graft outcomes with pretransplant donor and recipient characteristics. Organ quality, recipient immune status and ischemia reperfusion injury are valuable features and dictate transplant outcomes.