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Kidney Week

Abstract: PO2173

Early Experience with TruGraf in Kidney Transplant Recipients: The University of Maryland Medical Center Experience

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical


  • Haririan, Abdolreza, University of Maryland School of Medicine, Baltimore, Maryland, United States
  • Masters, Brian M., University of Maryland Medical Center, Baltimore, Maryland, United States
  • Booth, Ian A., University of Maryland Medical Center, Baltimore, Maryland, United States
  • Kalil, Roberto S., University of Maryland School of Medicine, Baltimore, Maryland, United States

TruGraf, an assay based on PBMC gene expression profile, has been recently introduced as a non-invasive screening tool for subclinical rejection in kidney transplantation. Its utility as a screening tool is currently not well defined. In this preliminary study we examined the predictive value of TruGraf for subclinical acute rejection, and its concordance with dd-cfDNA and DSA results.


In this small, retrospective cohort study, we examined the results of TruGraf in 48 kidney transplant recipients with stable graft function (median 12.9 mo posttransplant, IQR 5.9-19.8). Patients were maintained on TAC/MMF+/-prednisone. We collected data on 11 biposies, 17 dd-cfDNA, and 16 DSA assays performed within 1 mo of TruGraf.


There were 34 'TX" and 14 'Not-TX" results. 3 pts in former (1 with TCMR) and 8 in latter group (1 TCMR, 3 ABMR) had biopsies. Among those with DSA testing, out of 7 "Not-TX" cases 2 had DSA, compared with 4 out of 9 with "TX" (p=0.45). Combining biopsy results with DSA, "rejection or DSA" was present in 5/8 of "Not-TX" and 4/9 of "TX" groups (p=0.4). dd-cfDNA >1% was seen in 1/6 of "Not-TX" and 2/17 of "TX" cases, and 2/6 and 8/17, respectively, had values >0.5% (p=0.46). Comparing dd-cfDNA >0.5% and TruGraf, the former had 3/6 vs 4/6 negative results in absence of "rejection or DSA"; while positive results in presence of "rejection or DSA" was seen in 4/6 vs 2/6, respectively.


These preliminary observations in our cohort suggest that TruGraf could be a useful non-invasive tool for monitoring of allograft status in kidney transplant recipients. With implementing protocolized use of this test in our center along with dd-cfDNA and DSA screening at various time points, we will continue to prospectively collect data, and will be able to better define its utililty in our center toolbox.


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