The lack of an accurate biomarker makes it difficult to determine whether an organ is acceptable for transplantation. Mitochondrial DNA (mtDNA) correlates with tissue damage and kidney disease, making it a potential marker in organ quality evaluation. In this retrospective cohort study, we for the first time evaluated the value of plasma mtDNA in predicting posttransplant renal allograft outcomes. We found that donor plasma mtDNA was strongly related with donor acute kidney injury, and displayed significant correlation with respect to the prediction of posttransplant graft outcome. The plasma mtDNA level was markedly different in immediate graft function, slowed graft function(SGF), delayed graft function(DGF) and primary nonfunction(PNF) groups(0.039 versus 0.096, 0.178 and 0.302, respectively, p<0.001). The incidence of DGF and SGF increased more than four times(68% versus 16%, OR=4.3,p<0.001) in these donors' relative mtDNA level >0.114. The relative levels >0.243 led to 100% DGF and 44% PNF, while >0.285 esulted in 80% PNF or directly kidney discard. Moreover, donor plasma mtDNA level was an independent risk factor for SGF and DGF, a prediction model based on donor plasma mtDNA level achieved an area under the receiver operating characteristic curve for the prediction score as high as 0.844 (95%CI 0.771-0.916). Furthermore, donor plasma mtDNA level was correlated with 1-year graft survival(21% versus 1%,p<0.001) and 6-months allograft function (R²=0.332,p<0.001). In summary, this study showed for the first time that donor plasma mtDNA level predict post-transplantation allograft outcome, thus is valuable in organ evaluation; plasma mtDNA might serve as the first predictive marker for PNF, therefore worth further evaluation.

CITATION INFORMATION: Han F., Wan S., Chen N., Zheng L., Zhang N., Sun Q., Li H., Huang Z., Hong L., Sun Q. Donor Plasma Mitochondrial DNA Predicts Post-Transplant Renal Allograft Outcomes Am J Transplant. 2017;17 (suppl 3).

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