Barbara Murphy, MD, is the Principle Investigator of a study, the “Genomics of Chronic Renal Allograft Rejection,” (GoCAR), which aims to investigate the mechanisms leading to the development of transplant glomerulopathy, chronic arteriopathy funded through the NIH/NIAID Genomics Consortium in Transplantation. The study examines the contribution of the direct and indirect pathways of allorecognition, and the development of de novo donor specific antibodies to this pathologic finding in a large prospective group of renal transplant recipients. The studies is examining the gene expression profile associated with the development of chronic rejection using microarray on protocol biopsies performed over two years following transplantation. In addition, a larger cohort of donor and recipient pairs are being enrolled to identify polymorphic variants of specific immunological genes which confer susceptibility to chronic rejection and the development of donor specific antibodies.
Patients have been enrolled in 5 clinical sites including Mount Sinai, Westmead Hospital Sydney, University Wisconsin – Madison Medical Center, University of Michigan Medical Center, Ann Arbor, and Northwestern Medical Center. The findings of this study will lead to important insights into the pathologic mechanisms mediating chronic allograft loss. Initial finding suggest that differential gene expression on normal 3 month protocol biopsies may be potentially used to immunologically stratify transplant recipients.