Single Nuclei Transcriptomics Delineates Complex Interactions Between Immune and Renal Cells Contributing to Kidney Graft Fibrosis

Purpose: Chronic allograft dysfunction (CAD) remains a major obstacle in kidney transplantation. However, the molecular pathogenesis of human CAD is unknown. Herein, we tested the hypothesis that single nuclei transcriptomics of human kidney allograft fibrosis will reveal diverse cell types, deconvolve complex fibrosis-driving pathways, and provide deeper insights into the progression of kidney allograft dysfunction. Overall design: A total of 9 biospies were included: 6 from CAD patients with IFTA and 3 from patients with stable graft function with normal/nonspecific histopathology served as controls. Included samples were preserved in RNAlater and sequncing quality were compared to frozen samples kidney biopsies.