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Kidney Week

Abstract: TH-PO1155

Kidneys from African American Donors Are Associated with Accelerated Podocyte Detachment After Kidney Transplantation

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Naik, Abhijit S., University of Michigan, Ann Arbor, Michigan, United States
  • Aqeel, Jawad, University of Michigan, Ann Arbor, Michigan, United States
  • Cibrik, Diane Marie, University of Kansas Hospital, Parkville, Missouri, United States
  • Samaniego-Picota, Milagros D., Henry Ford Health Services, Detroit, Michigan, United States
  • Wang, Su Qing, University of Michigan, Ann Arbor, Michigan, United States
  • Chowdhury, Mahboob A., University of Michigan, Ann Arbor, Michigan, United States
  • Wiggins, Roger C., University of Michigan, Ann Arbor, Michigan, United States
Background

Kidneys from AA donors have reduced survival compared to kidneys from non-AA donors. Longitudinal histological data to better delineate the relationship of donor race, post-transplant histology and outcomes is lacking. We used urine nephron segment specific mRNA markers to understand whether kidneys from AA donors have different injury patterns than non-AA donors. We tested the hypothesis that high prevalence of glomerular disease in AA donors would be associated with differences in urine podocyte markers

Methods

We used a published cohort (Naik AS, et al, NDT, 2018) with linear mixed model with random intercept (pt. level) and slope (time post-transplant) with Urine Podocin mRNA:Urine creatinine ratio (UPodCR) as the dependent variable. The model was adjusted for an a priori selected group of variables

Results

534 urine samples from 125 recipients were analyzed. 14 recipients recieved kidneys from AA donors contributing to 59 urine samples. AA donors were younger (34 vs.41,p=0.04). Other characteristics were well balanced. One-year surveillance biopsy revealed no difference in burden of observable glomerular disease between AA and non-AA groups (p=0.21). There was no difference in proteinuria by donor race. Although at time of TP there was no difference in nephrin expression, by 1yr post-TP nephrin expression was significantly down-regulated in AA vs. non-AA groups. Figure 1 demonstrates factors associated with podocyte detachment.

Conclusion

These data are compatible with AA donors developing podocyte injury and loss that is observable prior to development of proteinuria or glomerular disease on surveillance biopsies. Further studies expanding the current cohort and assessing relationships of accelerated podocyte loss with APOL1 genotype are ongoing.

Donor AA race and rejection in 1st year were associated with accelerated podocyte detachment.

Funding

  • NIDDK Support