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MHH nephrologists find cells that provide information about the function of the kidney transplant after rejection.
A research team led by Prof. Dr Christian Hinze, senior physician at the MHH Clinic for Kidney and Hypertension Diseases at Hannover Medical School (MHH), has gained new insights into the treatment of kidney transplant patients. The team has discovered properties of kidney cells that, after rejection, provide information about how well a transplant will recover in the long term. ‘The transplant itself develops a kind of molecular memory of the rejection,’ says Professor Hinze. "The specific cell states we have identified can tell us how well the kidney is actually recovering. This makes them promising candidates for future diagnostic tools," says Professor Hinze, who is responsible for the follow-up care of kidney transplant patients at the MHH, among other things. The results were published in the journal Nature Communications.
Acute rejection causes the transplant to gradually lose its function
Despite being treatable, acute rejection remains one of the main causes of kidney transplant failure. Immune cells, known as T cells, recognise the transplant as foreign. They migrate into the organ, trigger inflammation and damage the tissue. If this process is not stopped with medication, the organ gradually loses its function.
Cells differ from healthy cells
Professor Hinze's research team, together with partners from Charité Berlin and the Alberta Transplant Applied Genomics Centre in Canada, investigated how the tissue of a transplanted kidney changes during and after such T-cell-mediated rejection. They showed that it is not only the immune cells that play a role, but above all the reaction of the cells of the renal tubule. The cells of the fine tubular system are responsible for central transport processes and respond to rejection with noticeable stress and repair patterns. ‘Some of these cell states clearly differ from healthy cells,’ explains Professor Hinze. ‘Some of them do not disappear even after successful treatment of the rejection and occur especially when the transplant has a high risk of failure later on.’
Large patient cohorts have shown that a high proportion of such cells in the biopsy can be a warning sign – an indication that the transplant is at risk in the coming years.
‘This opens up new possibilities for doctors to assess risks more accurately after rejection and to plan follow-up care more individually,’ says Prof. Dr. Kai Schmidt-Ott, Director of the MHH Clinic for Nephrology and co-author of the study. ‘The research results could help us identify kidney transplant patients who need a change in therapy or particularly close monitoring. And perhaps – future studies will have to show this – the newly discovered cellular programmes could even be therapeutically influenced at some point.’
In their work, the researchers combined data from experimental models, single-cell analyses, spatial gene expression and extensive biopsy collections. This provided a comprehensive picture of how tubular cell states arise, how they are distributed in the tissue and what significance they have for the long-term course. For the MHH, one of Europe's leading transplant centres, the results represent another step towards more precise, future-oriented transplant medicine.
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For further information, please contact Prof. Dr Christian Hinze, hinze.christian@mh-hannover.de.
https://www.nature.com/articles/s41467-026-68397-1
Prof. Dr Christian Hinze (right) and Prof. Dr Kai Schmidt-Ott discuss the results of spatial gene ex ...
Copyright: Karin Kaiser / MHH.
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