“Molecular rejection signatures in pancreas transplant biopsies” published in American Journal of Transplantation – a collaborative research study with IKEM in Prague.

Excited to share encouraging results of a study using the kidney MMDx process in pancreas transplants. MMDx kidney assessed a TCMR state in pancreas biopsies that correlated with the TCMR seen in histology. It did not detect a molecular ABMR state, however, it’s not yet clear if an ABMR state exists in pancreas. (ABMR is proven to exist in kidneys and hearts but not lungs and livers). These results set the stage for a full MMDx pancreas study to develop a pancreas specific biopsy system and see if pancreas ABMR exists.

Study highlights:

• Objective: Explore the applicability of kidney-derived MMDx to pancreas allograft biopsies (n = 124), its agreement with histology, and its association with graft outcomes.
• Diagnostic concordance: MMDx classified 15% of biopsies as rejection, compared with 58% by histology, with low concordance between methods (κ = 0.14, P < .001).
• Molecular–histologic correlation: Histologic acute cellular rejection grades correlated significantly with molecular scores for interstitial inflammation, T cell–mediated rejection, and acute kidney injury.
• Prognostic value: MMDx-detected rejection was strongly associated with inferior 3-year graft survival (HR 6.94, 95% CI 2.58–18.70; P < .001), whereas histologic diagnosis was not.
• Clinical significance: Kidney-derived MMDx may complement histologic assessment of pancreas allograft biopsies and provide additional prognostic information.