Abstract Background/Introduction Primary graft dysfunction (PGD) remains the leading cause of early mortality post-heart transplantation. Despite its incidence and impact the underlying biology of PGD is poorly understood. p-element-induced wimpy testis-interacting RNAs (piRNAs) has been reported as novel and promising disease biomarkers for cardiac allograft rejection. However, their potential utility in risk prediction of PGD remains unexplored. Purpose This study aimed to determine the diagnostic value of pretransplant circulating piRNAs on PGD in patients with heart transplantation (HT). Methods A total of 35 patients were included (22 non-PGD, 13 PGD). Plasma samples were collected from adult recipients before heart transplantation. piRNAs levels were determined by Small RNA sequencing technology. RNA extraction was performed using miRNeasy® Serum/Plasma Advanced Kit (Qiagen) and SMARTer smRNA-Seq Kit (Illumina) was used to construct libraries. cDNA samples were sequenced using the Illumina NovaSeq6000 instrument. Results The mean age of the patients was 57.9±8.3 years, and 71.4% were male. Levels of piR-1271839 and piR-2508608 were decreased in patients who developed PGD compared to non-PGD group (p0.01 and p0.001, respectively). The ROC curve analysis showed that the combination of these two piRNAs discriminate between non-PGD and PGD patients (AUC=0.927; p0.001), with a sensitivity of 85%, specificity of 91% and value predictive negative of 91%. Conclusion This study suggests the utility of pretransplant piRNAs levels, specifically piR-1271839 and piR-2508608, as non-invasive predictors of PGD in patients undergoing HT.
Torrent et al. (Sat,) studied this question.