Early Postreperfusion Proteomics Reveal Divergent Inflammatory Responses in Kidney Transplantation with Implications on Outcomes
Transplantation, 2025
Strandberg G., Raihle C., Nilsson B., Öberg C., Blom A., Axman S., Slivca O., Paul C., Berglund D., Biglarnia A.
| Disease area | Application area | Sample type | Products |
|---|---|---|---|
Immunological & Inflammatory Diseases | Patient Stratification | Plasma |  Olink Target 96 |
Abstract
Background.
Ischemia/reperfusion injury is an unavoidable consequence of kidney transplantation, yet the characteristics of the immediate immune response after reperfusion and its impact on transplant outcomes remain poorly characterized in the clinical setting.
Methods.
We conducted a cohort study including 63 kidney transplant recipients (26 living-donor, 37 deceased-donor) with an extended 4-y follow-up to characterize early postreperfusion inflammatory dynamics and their association with transplant outcomes. Using high-throughput proteomics, we profiled 92 inflammatory markers in the early reperfusion stage. Intraoperative blood samples were collected systemically at baseline and from the transplant vein at 1, 10, and 30 min postreperfusion.
Results.
Our analysis revealed a pronounced early immune response on reperfusion, with distinct inflammatory trajectories between living- and deceased-donor kidney allografts. Living-donor allografts showed proteomic patterns suggestive of a regulatory response, whereas deceased-donor allografts exhibited patterns associated with a cell injury-related response. Notably, interleukin-33 and hepatocyte growth factor were associated with delayed graft function, whereas hepatocyte growth factor also correlated with long-term allograft dysfunction.
Conclusions.
These findings underscore the potential of assessing early postreperfusion inflammation to improve clinical risk stratification and guide future biomarker validation efforts.