Current screening for lung donor suitability is based on a number of empirical criteria such as donor age, smoking history, arterial blood gas concentrations, chest radiograph findings, bronchoscopic findings and physical examination of the lung at the time of organ retrieval. While these criteria have proven effective, they are imprecise and often lead to rejection of organs that are potentially suitable for transplantation. This has led to lung recovery from only 20% of the available donor pool. The availability of biomarkers that predict outcome after transplantation will greatly assist the clinical assessment of lung donor suitability and potentially improve the efficiency of donor organ utilization and at the same time, improve recipient outcome.

Dr. Shaf Keshavjee and colleagues have identified a panel of biomarkers that are differentially expressed in donor lungs. These biomarkers are highly predictive of the risk of primary graft failure in recipients. Using this information, they have developed a new gene-based diagnostic tool that will assist in the clinical assessment of lung donor suitability. In this invention, gene expression is calculated for a specific pair of up-regulated and down-regulated biomarkers or specific cytokine pairs, wherein the value of the gene ratio is indicative of the risk of primary graft failure post-transplantation. This gene ratio model is considered to be more predictive than monitoring expression levels of individual biomarkers alone. It has been demonstrated that the use of specific gene ratio pairs achieved greater than 90% diagnostic accuracy.

These biomarkers can be developed into novel diagnostic assay kits for lung transplant and can be used in conjunction with current selection criteria to improve screening of lung donor suitability in transplantation. It is anticipated that such a diagnostic assay would have large market demand as it would improve the efficiency donor lung utilization and improve transplant recipient outcomes.

Related Publication:
Kaneda, H., et al. Pre-implantation multiple cytokine mRNA expression analysis of donor lung grafts predicts survival after lung transplantation in humans. Am J Transplant. 6(3), 544-51 (2006)

File Number: 5021 

Web site: http://www.uhnresearch.ca/tdc

Disease: Respiratory and Pulmonary System