Transcriptional Responses Define Dysregulated Immune Activation in Hepatitis C (HCV)-Naïve Recipients of HCV-Infected Donor Kidneys

In this study, we evaluated transcriptional responses in circulating leukocytes to assess for biomarkers of adverse outcomes in transplant patients after transplantation from a HCV-infected donor. We enrolled renal transplant recipients with and without HCV and performed RNA sequencing on serial samples. CMV DNAemia and allograft rejection outcomes were measured. Regularized logistic regression was utilized to develop gene expression classifiers predictive of clinical outcomes. 67 renal transplant recipients were included in this analysis (30 controls, 37 HCV recipients); serial samples were collected from the first month after transplant, 3 months post-transplant, and 6 months post-transplant; total RNA was extracted from human blood by PAXgene and RNA sequencing was performed.