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Urinary Renal Progenitors Isolation: A Novel Predictor of Kidney Graft Outcome.

A. Manonelles,1 O. Bestard,1 M. Goma,1 P. Romagnani,2 J. M. Cruzado.1

1Hospital Univ Bellvitge, Barcelona, Spain
2Meyer's Children Hosp, Firenze, Italy

Meeting: 2017 American Transplant Congress

Abstract number: A119

Keywords: Kidney transplantation, Outcome, Stem cells

Session Information

Session Name: Poster Session A: Diagnostics/Biomarkers Session I

Session Type: Poster Session

Date: Saturday, April 29, 2017

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Hall D1

Background: Longterm kidney allograft outcomes remain as unmet need. Most studies focus on mechanisms of graft injury, and kidney reparative mechanisms are neglected. Isolation of Renal Progenitors from urine (uRP) is possible and may be a potential tool to evaluate intrinsic regenerative graft capacity.

Methods: We included 66 recipients at the time 6 month protocol biopsy. After cell culture, uRP were FACs cell-sorted (CD24/CD133), and gene expression profile performed. Clinical (demographic parameters, type, treatment), analytical (GFR, proteinuria) and immunological data (donor specific antibodies, ELISPOT, urinary CXCL9 and 10) were assessed. Kidney biopsies were evaluated according to Banff classification, and CD133/CD44 staining was performed. We followed this cohort for 1 yr.

Results: uRPs were isolated in 62% patients at the time of 6-m protocol biopsy. Therefore we divided patients in two groups: Group A having uRP and Group B without uRP. Study groups were comparable regarding baseline characteristic, immunosuppression, DGF, acute rejection, GFR and proteinuria. Protocol biopsy evaluation was similar between groups, without differences for particular Banff items. Glomerular CD44 staining showed no differences. T-cell IFN-γ ELISPOT assay, donor specific antibody determination and urinary biomarkers were comparable. Cells showed similar gene profile compared to healthy tissue progenitors. The variation of GFR between months 6 to 12 showed that patients with uRP at 6m had a significant increase of GFR at 12m in comparison with stabilization of renal function in patients without uRP.

uRP+ (n=41) uRP- (n=25) P value
GFR 6m 56±16 59±19 0.5
Proteinuria 16±13 13±13 0.4
DSA 6m (%P) 7 8 0.5
Tcell ELISPOT 17.4±21 22.5±22 0.6
U Biomarkers (%P) 0 0 0.6
Glom-Scl (%P) 35 36 0.99
Inflammation (%P) 47 50 0.99
IFTA (%P) 39 41 0.99
[Delta]GFR 6-12 (%) +10±2 -3±1 0.003

Conclusions: The presence of renal progenitors on urine of kidney recipients at 6 months identifies a subgroup of patients with significant improvement of GFR at 1 year, despite showing similar effector mechanisms of damage, renal function and 6-month graft histology compared to patients without uRPC.

This finding raises new prospects as novel predictors of better graft outcomes.

CITATION INFORMATION: Manonelles A, Bestard O, Goma M, Romagnani P, Cruzado J. M. Urinary Renal Progenitors Isolation: A Novel Predictor of Kidney Graft Outcome. Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Manonelles A, Bestard O, Goma M, Romagnani P, Cruzado JM. Urinary Renal Progenitors Isolation: A Novel Predictor of Kidney Graft Outcome. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/urinary-renal-progenitors-isolation-a-novel-predictor-of-kidney-graft-outcome/. Accessed May 25, 2025.

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