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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Allograft rejection remains a leading cause of graft dysfunction and loss in kidney transplantation. In resource-constrained settings, comprehensive immunological profiling is often limited, necessitating reliance on clinical predictors and pharmacogenomic tools. Calcineurin inhibitors (CNI), though central to immunosuppression, show marked pharmacokinetic variability influenced by CYP3A5 genotype. This study evaluated clinical, pharmacogenomic, and therapeutic drug monitoring factors associated with rejection and outcomes in renal transplant recipients.
We retrospectively analyzed renal allograft recipients transplanted between 2022–2024 at a tertiary center in South India. Patients with complete follow-up and pharmacogenomic data were included; those with incomplete records were excluded. Rejection was defined as biopsy-proven acute cellular rejection (ACR) or antibody-mediated rejection (ABMR) or both. Clinical and donor characteristics, induction regimen, graft kinetics, CYP3A5 genotype (expressors vs non-expressors), and tacrolimus trough concentration-to-dose (C0/D) ratios at predefined timepoints (POD-4, 1M, 3M, 6M, 1Y, and at rejection) were analyzed. Statistical tests included Chi-square, t-test/Mann–Whitney, and logistic regression.
Of the total 163 transplants, 25 died due to various causes( most common cause being sepsis ), 11 underwent graft nephrectomy ( among which 5 died ). So, a total of 132 cases were analysed. 41 patients had rejection among the 163 patients. Among 132 patients, 99 (75%) were male. 86.4% had hypertension, 64 patients had history of blood transfusion. On analyzing the correlation between phenotype and genotype, throughout various timepoints, C0/D ratio strongly mirrored the genotype, with expressors having lesser C0/D & non-expressors having higher C0/D – indicating faster and slower metabolisms respectively (p<0.001). Median incidence of rejection in the post-transplantation period varied among the Fast Metabolizer (5 months) and Slow Metabolizer (30 Months).
Rejection incidence in our center was higher (26.3%) than global benchmarks, reflecting resource constraints in immunological profiling. Pharmacogenomic correlation with tacrolimus metabolism demonstrated a strong impact on rejection risk, with CYP3A5 expressors and lower C0/D ratios predicting early rejection. Incorporating pharmacogenomic profiling and routine C0/D monitoring, alongside optimized induction strategies, may mitigate rejection risk in resource-limited settings.
