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Pre-Transplant CDKN2A Expression in Kidney Biopsies Predicts Renal Function and Is a Future Component of Donor Scoring Criteria
Authors:Marc Gingell-Littlejohn  Dagmara McGuinness  Liane M McGlynn  David Kingsmore  Karen S Stevenson  Christian Koppelstaetter  Marc J Clancy  Paul G Shiels
Institution:1. University of Glasgow, College of Medical, Veterinary and Life Sciences, Institute of Cancer Sciences, Glasgow, United Kingdom.; 2. Transplant Unit, Western Infirmary, Glasgow, United Kingdom.; 3. Division of Nephrology, Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria.; INSERM, France,
Abstract:CDKN2A is a proven and validated biomarker of ageing which acts as an off switch for cell proliferation. We have demonstrated previously that CDKN2A is the most robust and the strongest pre-transplant predictor of post- transplant serum creatinine when compared to “Gold Standard” clinical factors, such as cold ischaemic time and donor chronological age. This report shows that CDKN2A is better than telomere length, the most celebrated biomarker of ageing, as a predictor of post-transplant renal function. It also shows that CDKN2A is as strong a determinant of post-transplant organ function when compared to extended criteria (ECD) kidneys. A multivariate analysis model was able to predict up to 27.1% of eGFR at one year post-transplant (p = 0.008). Significantly, CDKN2A was also able to strongly predict delayed graft function. A pre-transplant donor risk classification system based on CDKN2A and ECD criteria is shown to be feasible and commendable for implementation in the near future.
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