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Title: A Peripheral Blood Diagnostic Test for Acute Rejection in Renal Transplantation
Authors: Li, L ×
Khatri, P
Sigdel, T K
Tran, T
Ying, L
Vitalone, M J
Chen, A
Hsieh, S
Dai, H
Zhang, M
Naesens, Maarten
Zarkhin, V
Sansanwal, P
Chen, R
Mindrinos, M
Xiao, W
Benfield, M
Ettenger, R B
Dharnidharka, V
Mathias, R
Portale, A
McDonald, R
Harmon, W
Kershaw, D
Vehaskari, V M
Kamil, E
Baluarte, H J
Warady, B
Davis, R
Butte, A J
Salvatierra, O
Sarwal, M M #
Issue Date: Oct-2012
Publisher: Munksgaard International Publishers
Series Title: American Journal of Transplantation vol:12 issue:10 pages:2710-2718
Article number: 10.1111/j.1600-6143.2012.04253.x
Abstract: Monitoring of renal graft status through peripheral blood (PB) rather than invasive biopsy is important as it will lessen the risk of infection and other stresses, while reducing the costs of rejection diagnosis. Blood gene biomarker panels were discovered by microarrays at a single center and subsequently validated and cross-validated by QPCR in the NIH SNSO1 randomized study from 12 US pediatric transplant programs. A total of 367 unique human PB samples, each paired with a graft biopsy for centralized, blinded phenotype classification, were analyzed (115 acute rejection (AR), 180 stable and 72 other causes of graft injury). Of the differentially expressed genes by microarray, Q-PCR analysis of a five gene-set (DUSP1, PBEF1, PSEN1, MAPK9 and NKTR) classified AR with high accuracy. A logistic regression model was built on independent training-set (n = 47) and validated on independent test-set (n = 198)samples, discriminating AR from STA with 91% sensitivity and 94% specificity and AR from all other non-AR phenotypes with 91% sensitivity and 90% specificity. The 5-gene set can diagnose AR potentially avoiding the need for invasive renal biopsy. These data support the conduct of a prospective study to validate the clinical predictive utility of this diagnostic tool.
ISSN: 1600-6135
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Nephrology
× corresponding author
# (joint) last author

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