N.C. – July 31, 2018 – Researchers at Wake Forest Baptist Medical
Center have shown that gene expression analysis of blood samples taken from the
recipients of transplanted kidneys can be used to better understand the
mechanisms that promote repair and regeneration of the transplanted organs.
pilot study, published ahead of print
by the journal Annals
of Surgery, marks the first demonstration that blood can be used for this
want to know exactly what happens in the body during the first 30 days
following kidney transplantation,” said the study’s lead author, Giuseppe
Orlando, M.D., Ph.D., assistant professor of transplant surgery at Wake Forest
Baptist. “Kidney biopsies have traditionally been used to gain insights into
post-transplant physiology, but the invasive nature of acquiring biopsy tissue
prevents multi-time point investigation of the molecular events that occur in
the initial post-transplant period. This study shows that profiling gene
expression in blood samples offers a viable alternative.”
used blood taken over 30 days in routine draws from 15 kidney transplant
recipients, five of whom received an organ from a living donor and 10 with
organs from deceased donors. Gene expression analysis – which examines the
amounts of RNA available to be transcribed into proteins – revealed that in all
15 subjects the most robust gene expression changes occurred in the first day
following transplantation and subsided by the end of the 30-day period.
while the over expression of most genes fell off markedly after the first day
in the living-donor group, the expression of a large number of genes remained
elevated among recipients of deceased donor kidneys. Comparison between living
donors and non-living donors groups helped to identify 11 genes that may be key
players in kidney repair and regeneration after damage.
kidneys from deceased donors don’t always work right away, which means that
recipients may still need dialysis or other treatment after the transplant,”
Orlando said. “If we will be able to identify the ‘magic stick’ that
orchestrates the repair and regeneration process in the kidney, perhaps we can
find a way to boost it or speed it up.
the future, we hope this information will help us treat other conditions characterized
by impairment of the renal function, as well as help transplanted kidneys function
as soon as possible.”
studies that involve a larger number of subjects, more blood-collection points
and additional data analysis will be needed to validate the findings of the
pilot study, Orlando said.
of the study are Lauren Edgar, B.S., Emily Gall, B.A., Christopher Bergman,
B.S., Riccardo Tamburrini, M.D., Carlo Gazia, M.D., Alan C. Farney, M.D.,
Ph.D., Barry I. Freedman, M.D., Gwen McPherson, B.S., Hayrettin Okut, Ph.D.,
Jeffrey Rogers, M.D., Robert J. Stratta, M.D., and Stephen J. Walker, Ph.D., of
Wake Forest Baptist; Richard Danger, Ph.D., and Sophie Brouard, Ph.D., of the
University of Nantes, France; and Benedetta Bussolatti, M.D., Ph.D., of the
University Of Turin, Italy.