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• W2898893923 abstract "ABSTRACT There is a lack of biomarkers for pre-kidney transplant immune risk stratification to avoid over- or under-immunosuppression. Since the circulating lipidome is integrally involved in inflammation, we hypothesized that the lipidome may provide biomarkers that are helpful in the prediction of antibody-mediated rejection. We used mass spectrometry to detect the plasma lipidome in samples collected over 1 year post-kidney transplant from a prospective, observational cohort of adult kidney transplant recipients (KTR), classified in two groups, one with antibody mediated rejection (AMR) and the other with stable graft function (SC). We used linear discriminant analysis to generate predictive models of rejection. A ‘lipid-only’ model generated from samples taken on day of transplant (T1) revealed a seven lipid classifier (lysophosphatidylethanolamine and phosphatidylcholine species) with misclassification rate of 8.9% [AUC = 0.95 (95% CI = 0.84-0.98), R 2 = 0.63]. A clinical model [(using donor specific antibody (DSA) and panel reactive antibody (PRA)] was inferior with a misclassification rate of 15.6% [AUC = 0.82 (95% CI = 0.69-0.93), R 2 = 0.41]. A combined model using four lipid classifiers and DSA improved the AUC further to 0.98 (95% CI = 0.89-1.0, R 2 = 0.83) with a misclassification of only 2.2%. The polyunsaturated phospholipid subspecies that discriminated the two groups were much lower in the AMR group when compared to the SC group. While the lipidomic profile changed significantly among SC patients on serial sampling post-transplant, such changes were not seen in AMR patients. After taking serial lipidomic changes overtime in SC patients in to account, the AMR group still showed sustained decreased levels of specific lipids at the time of AMR. These findings suggest that a lack of anti-inflammatory polyunsaturated phospholipids could identify patients at a higher risk of AMR at the time of transplant." @default.
• W2898893923 created "2018-11-09" @default.
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• W2898893923 date "2018-11-01" @default.
• W2898893923 modified "2023-10-15" @default.
• W2898893923 title "A Pre-transplant Blood-based Lipid Signature for Prediction of Antibody-mediated Rejection in Kidney Transplant Patients" @default.
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• W2898893923 doi "https://doi.org/10.1101/460030" @default.
• W2898893923 hasPublicationYear "2018" @default.
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