Pgm #82: Applying Genetic Technologies to Transplantation Patient Care

Approximately 3.5 million to 10 million genetic variants exist between the genomes of unrelated donors and recipients. While genetic compatibility in one key region, Human Leukocyte Antigen (HLA), is known to be important for graft survival, recent evidence shows that non-HLA allogenicity accounts for more than twice that of HLA in kidney transplantations. Large inter-individual difference in the metabolism of tacrolimus, the most commonly prescribed immunosuppression therapy (IST), are also shown to have significant genetics underpinnings. We recently formed The International Genetics & Translational Research in Transplantation Network (iGeneTRAiN) to perform genetic screening in >34,500 recipients/donors from 28 transplant studies across Europe and North America. A number of highly specific and sensitive biomarker panels for detection of sub-clinical rejection are nearing clinical implementation by us and others.