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Kidney Week

Abstract: PO2193

Kidney Injury in Hematopoietic Stem Cell Transplant (HCT) Recipients: Transcriptome Profiling and Development of Urinary Biomarkers

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Varma, Elly, Weill Cornell Medicine, New York, New York, United States
  • Salinas, Thalia, Weill Cornell Medicine, New York, New York, United States
  • Li, Carol Y., Weill Cornell Medicine, New York, New York, United States
  • Snopkowski, Catherine, Weill Cornell Medicine, New York, New York, United States
  • Muthukumar, Thangamani, Weill Cornell Medicine, New York, New York, United States
Background

In kidney biopsies of HCT recipients, thrombotic microangiopathy with/without tubulointerstitial/microvascular inflammation suggest the possibility of kidney being a target of graft versus host disease.
We tested the hypothesis: (i) kidney inflammation/injury in HCT recipients is immune mediated, (ii) urinary mRNA profile may be used as a noninvasive biomarker.

Methods

(i) RNA-sequencing of native kidney from 6 HCT recipients with kidney injury was performed. We compared the transcriptome profile to that of allograft kidney.

(ii) Urine samples from 9 HCT recipients were collected. We calculated the CTOT-04 signature score for each recipient. We compared the score to that of kidney allograft recipients.

Results

Of the 4188 genes (26% of 16375) that were different (FDR-P<0.05) between HCT and Normal, 2152 were shared among HCT, ACR, and AMR; 1442 were unique to HCT (Figure 1). Shared genes revealed enrichment of innate and adaptive immune system pathways. Urinary cell CTOT-04 signature score was higher in AKI/tubulitis and interstitial inflammation in the native kidney and resembled ACR of kidney allograft recipients (Figure 2).

Conclusion

In recipients of HCT:
(i) kidney inflammation/injury is immune mediated,
(ii) urinary cell mRNA profiling is useful for diagnosing kidney injury