Abstract: FR-PO1197
Association Between Tutivia Biomarker Scores and Clinically Defined Immune States in Kidney Transplant Recipients
Session Information
- Transplantation: Clinical - Rejection, Biomarkers, and Pharmacology
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Ahmed, Ahmed Khalafalla Mohamed, University of Illinois Chicago, Chicago, Illinois, United States
- Patel, Nirali Sanjay, University of Illinois Chicago, Chicago, Illinois, United States
- Hajjiri, Zahraa, University of Illinois Chicago, Chicago, Illinois, United States
Background
Immune monitoring after kidney transplantation remains challenging, particularly when distinguishing rejection from infection or over-immunosuppression. Tutivia is a next-generation sequencing–based peripheral blood RNA assay that analyzes expression of 17 immune-related genes to generate a composite rejection-risk score. We evaluated the association between Tutivia scores and clinically defined immune states in kidney transplant recipients.
Methods
We retrospectively analyzed 65 kidney transplant recipients with Tutivia testing performed within 1 month prior to biopsy. Patients were stratified into three clinically defined immune states: balanced, over-immunosuppressed, and under-immunosuppressed. Balanced immune state was defined by stable graft function without rejection, infection, or significant immunosuppression changes. Over-immunosuppressed state included BK/CMV infection, opportunistic infections, leukopenia requiring MMF reduction, or supratherapeutic tacrolimus levels. Under-immunosuppressed state included biopsy-proven rejection, borderline rejection, or development of de novo donor-specific antibodies. Tutivia scores were compared across immune-state groups as continuous variables.
Results
Baseline characteristics are summarized in Figure 1. Tutivia scores varied across immune-state groups, with lower scores observed in over-immunosuppressed patients and higher scores in balanced and under-immunosuppressed patients; however, differences were not statistically significant (p=0.106). Median scores were 31.5 (IQR 22.5–50.0) in balanced patients, 15.0 (IQR 9.0–41.0) in over-immunosuppressed patients, and 37.0 (IQR 13.3–57.0) in under-immunosuppressed patients (Figure 1).
Conclusion
Tutivia scores varied across clinically defined immune states, with lower scores observed in over-immunosuppressed patients and higher scores in balanced and under-immunosuppressed patients, although these differences were not statistically significant. Larger prospective studies are needed to further define the role of Tutivia in post-transplant immune monitoring and immune-state stratification.