Multiomics profiling of kidney transplant biopsies

Kidney transplant rejection is a major challenge in transplant medicine, and accurate diagnosis is essential for guiding therapy and monitoring graft health. This thesis aims to improve the diagnostic evaluation of kidney transplant biopsies by integrating advanced molecular and multiplex immunohistochemical approaches alongside traditional histopathology. Using multiplex immunofluorescence (mIF) staining and transcriptomic profiling with the Banff-Human Organ Transplant (B-HOT) panel, this research explores the immune cell composition and gene expression profiles in different rejection phenotypes.

The work reveals that mIF can effectively identify and localize key immune cell populations—including T cells, B cells, macrophages, and mast cells—within the tissue, enhancing the visualization of complex immune responses. Complementary transcriptomic analyses provide insights into gene expression signatures associated with various rejection types and transplant injuries, including challenging cases like transplant glomerulopathy with ambiguous histological features. These combined methods help to uncover novel patterns and relationships that may not be evident through standard microscopy alone.

By merging molecular and histological data, this thesis demonstrates the potential to refine the interpretation of kidney transplant biopsies. This integrated approach contributes to a more precise and reproducible diagnostic framework, supporting better understanding of rejection mechanisms and offering a valuable resource for both pathologists and the transplant community in the pursuit of improved transplant outcomes.