Abstract: PUB362
Gene-Environment Interactions in Kidney Transplantation: Implications for Patient Outcomes
Session Information
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Rabideau, Kate, Saint Louis University School of Medicine, St. Louis, Missouri, United States
- Aydin, Orhun, Saint Louis University, St. Louis, Missouri, United States
- Truong, Dzuy, Saint Louis University School of Medicine, St. Louis, Missouri, United States
- DeLonais-Parker, Ava, Saint Louis University School of Medicine, St. Louis, Missouri, United States
- Unes, Meghan Marie, Saint Louis University School of Medicine, St. Louis, Missouri, United States
- Befeler, Jaime, Saint Louis University School of Medicine, St. Louis, Missouri, United States
- Lentine, Krista L., Saint Louis University School of Medicine, St. Louis, Missouri, United States
- Caliskan, Yasar, Saint Louis University School of Medicine, St. Louis, Missouri, United States
Background
Genetic testing is rapidly becoming a popular tool in evaluating patients with chronic kidney disease (CKD) for kidney transplant (KTx); however, these tools alone are insufficient in predicting transplant outcomes. The goal of this study is to evaluate the intersection of genetics and patient environment in establishing transplant evaluation and outcome. Increased information on this topic will help inform risk of disease recurrence, guide management and assess possible donors.
Methods
A retrospective study was conducted on a cohort of 360 patients with CKD between 2015 and 2024. The primary outcome was renal transplant. Demographic variables analyzed included genetic testing result (positive or negative), family history of renal disease, sex, age, ancestry, current renal replacement therapy, and cause of CKD. Environmental factors were evaluated based on patient zip code and included soil heavy metal levels and fine particulate matter (PM2.5) levels. A Random Forest (RF) model between demographic, environmental, and renal transplant variable it defined.
Results
Of the 360 CKD patients evaluated, 80 were transplanted (22.2%) and 280 patients were not transplanted (77.8%) by the study end date. The average patient was 49.6 years old, with a male predominance (83.1%). Figure 1 depicts variables that were shown to have the most impact on receiving renal transplantation as cause of CKD, renal replacement therapy pre-transplant, PM2.5 levels and levels of soil cadmium, and uranium and maximum annual PM2.5, respectively. Variables that had less of an impact on renal transplantation were genetic testing, family history, sex, age, and ancestry.
Conclusion
In this study, environmental factors such as levels of heavy metals in soil and FM2.5 had more influence on likelihood of renal transplantation than genetic testing results. This study highlights the need for better understanding of patient environment and how it impacts transplant availability and outcomes.