Transglutaminase type 2 (TG2) is an extracellular matrix crosslinking enzyme with a pivotal role in kidney fibrosis. We tested the hypothesis that quantification of urinary TG2 is a noninvasive method to estimate the severity of kidney allograft fibrosis. We prospectively collected urine specimens from nine cadaveric kidney transplant recipients post-transplant one day, seven days, one month, three months, and six months. In addition, kidney allograft tissue specimens at zero-day and six-months post-transplant were sampled to analyze the correlation of urinary TG2 and kidney allograft fibrosis. Six recipients (the aggravation group) had borderline cellular rejection or chronic score (ct+ci) increase at six-months protocol biopsy compared with those at zero-day biopsy. Mean level of urinary TG2 in the aggravation group was significantly lower compared with that in other three recipients (the control group) at post-transplant one day (0.0496±0.0556 vs 0.2393±0.0624, p=0.004) and one month (0.0090±0.0078 ng/ml 0.1642±0.0886 ng/ml, p=0.026). In addition, the difference in chronic scores between zero-day and six-months biopsies was inversely correlated with urinary TG2 level at post-transplant one day (R²=0.729, p=0.04). In the aggravation group, double immunofluorescent staining revealed that TG2 intensity was significantly upregulated and colocalization of TG2/heparin sulfate proteoglycan was prominent, usually around tubular structures. In conclusion, urinary TG2 in early post-transplant periods is a potent biomarker for kidney allograft inflammation or fibrosis.

CITATION INFORMATION: Shin S, Wee Y.-M, Choi M, Cho Y, Go H, Kim Y, Han D. Post-Transplant Urinary Transglutaminase 2 Is a Potent Biomarker to Predict Kidney Allograft Inflammation or Fibrosis. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress