Blood marker may predict kidney transplant failure risk

2020 01 16 18 27 4229 Kidney 400

French researchers have found that the composition of particular immune cells in the blood a year after a kidney transplant is associated with a patient's risk of transplant failure, according to a study published online March 12 in the Journal of the American Society of Nephrology.

The results could help clinicians better intervene before patients experience transplant rejection, wrote corresponding author Nicolas Degauque, PhD, of the Université de Nantes, France, and colleagues.

"As kidney transplantation remains the best therapeutic option for end-stage renal disease, and considering that current immunosuppression approaches inefficiently treat chronic rejection, favorable kidney graft survival requires the design of innovative preventive tools and therapeutics adapted to patients' individual risks," the group wrote.

Kidney transplant patients use immunosuppressive medication to prevent their immune systems from rejecting the transplanted organ, but for many, this rejection still occurs, Degauque and colleagues noted. That's why it's important to pinpoint biomarkers that could help predict kidney transplant failure.

"Identifying biomarkers to predict kidney transplant failure and to define new therapeutic targets requires more comprehensive understanding of the immune response to chronic allogeneic stimulation," the team wrote.

So Degauque's group conducted a study that included blood samples from 284 kidney transplant recipients who were followed for a median of eight years, which they analyzed for particular biomarkers.

The researchers found that the composition of immune cells called CD8+ memory T cells one year after kidney transplantation was associated with a patient's subsequent risk of transplant failure. They also found that specific types of these, called effector memory-expressing CD45RA cells, are the key instigators of immune-related processes that lead to kidney transplant failure.

"At [one-year post-transplant], the composition of memory CD8+ T cell subsets in blood improved prediction of [eight-year] kidney transplant failure compared with a clinical variables score alone," the group wrote.

The study's conclusions could help clinicians better identify patients at risk of transplant failure, Degauque said in a statement released by the American Society of Nephrology (ASN), publisher of the JASN.

"The findings are important because early identification of at-risk kidney transplant recipients is critical to allow physicians to adapt their care," he said.

The results also suggest that research on effector memory expressing CD45RA cells could be promising for new treatment or prevention strategies against organ rejection.

"[Our] findings suggest that [these cells] play a pivotal role in humoral and cellular rejection and reveal the potential of memory CD8+ T cell monitoring for predicting risk of kidney transplant failure," the group concluded.

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