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The Use of Cell-Free MicroRNAs for the Diagnosis of Allograft Rejection in Liver Transplant Recipients Using Standard and Novel Direct Detection Platforms

T. Kohut1, B. Chang2, J. Wen1, A. Shaked2, B. Keating2

1Division of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, 2Hospital of the University of Pennsylvania, Penn Transplant Institute, Philadelphia, PA

Meeting: 2020 American Transplant Congress

Abstract number: B-331

Keywords: Genomics, Immunosuppression, Liver transplantation, Rejection

Session Information

Session Name: Poster Session B: Biomarker Discovery and Immune Modulation

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Standard immunosuppression therapy (IST) in liver transplant (LTx) recipients requires a delicate balance to prevent side effects and allograft rejection (AR). There is no current method to personalize IST. Minimally-invasive biomarkers diagnostic and prognostic of AR are needed. MicroRNAs (miRNAs), non-coding RNA molecules regulating gene expression, are attractive AR biomarkers. The purpose of our study was to replicate previously discovered AR-miRNAs in another adult cohort and in a novel pediatric cohort utilizing qRT-PCR and introduce a novel direct detection approach.

*Methods: miRNA profiling was performed using qRT-PCR for 179 human miRNA targets on adult and pediatric sera prospectively collected in LTx recipients at liver biopsy and correlated with outcomes of AR versus non-AR. miRNA profiling was also performed in adult sera collected pre- or post-AR event for the same patient. Associations between AR status and miRNA abundance were tested using generalized linear models. Direct detection of miR-122-5p was performed using a novel technology on subsets of adult and pediatric sera. Associations between standard and direct detection platforms were tested using Pearson correlation.

*Results: In adult AR (n=41) vs. non-AR (n=78), the top significant AR-miRNAs (fold change ≥2 & p<1.0x10-4) overlapped with previously discovered miRNAs. In adult AR vs. pre- or post-AR event in the same patient (n=29), the top significant AR-miRNAs (fold change ≥3 & p<2.0x10-5) also overlapped with previously discovered miRNAs with larger fold changes. In pediatric AR (n=17) vs. non-AR (n=12), the top significant adult AR-miRNAs showed the same association direction. The top significant pediatric AR-miRNAs (fold change ≥2 & p<0.01) largely coincided with adult top AR-miRNAs. High correlation was seen between qRT-PCR and direct detection platforms for miR-122-5p (Pearson correlation=0.948, p<1.0x10-20) (Figure 1).

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*Conclusions: AR-miRNAs previously discovered were replicated in an additional adult cohort with largest fold changes in paired comparisons, indicating that within subject trends are more profound. Pediatric AR-miRNAs showed similar trends with adults, suggesting that adult AR-miRNA signatures may be applicable to pediatrics. Future directions will focus on developing a multiplex AR-miRNA panel using a direct detection platform.

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To cite this abstract in AMA style:

Kohut T, Chang B, Wen J, Shaked A, Keating B. The Use of Cell-Free MicroRNAs for the Diagnosis of Allograft Rejection in Liver Transplant Recipients Using Standard and Novel Direct Detection Platforms [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/the-use-of-cell-free-micrornas-for-the-diagnosis-of-allograft-rejection-in-liver-transplant-recipients-using-standard-and-novel-direct-detection-platforms/. Accessed May 16, 2025.

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