MicroRNAs 155-5p, 122-5p and 181a-5p identify patients with graft dysfunction due to T-cell mediated rejection after liver transplantation.Liver Transpl. 2020 Jul 02 [Online ahead of print]LT
MicroRNAs (miRNAs) are small non-coding RNAs that can be detected in plasma and whose expression is associated with pathological processes. The role of miRNAs in the non-invasive diagnosis of T-cell mediated rejection (TCMR) after liver transplantation is unclear. Thus, we aimed to assess the effectiveness of a panel of four miRNAs (155-5p, 122-5p, 181a-5p and 148-3p) in diagnosing TCMR in liver transplant recipients with graft dysfunction (GD), and compare its accuracy with previously published tests for diagnosing TCMR based on routine laboratory parameters. From a prospective cohort of 145 patients followed during the first year after transplant, 49 developed GD and underwent a liver biopsy and plasma collection for miRNA analysis using qPCR. Patients with GD due to TCMR (n=21) exhibited significantly higher (p<0.001) expression of miRNA 155-5p (2.05 vs 0.07), 122-5p (19.36 vs 1.66) and 181a-5p (1.33 vs 0.37) compared to those with GD from other causes (n=28). The AUROC of miRNAs 155-5p, 122-5p and 181a-5p for the diagnosis of TCMR was 0.87, 0.91 and 0.89 respectively, significantly higher than those of the other non-invasive tests (p<0.001). Furthermore, miRNA 155-5p identified all patients who presented TCMR during the first two weeks after transplant.