Exploring Telomere Association in Donor-Recipient Pairs: Implications for Kidney Graft Longevity

INTRODUCTION: Telomeres, which protect chromosome ends, are important in cell replication and are altered by ageing. In the realm of organ transplantation, telomere length has emerged as a potential biomarker for predicting both graft survival and recipient longevity. This study explores the correlation of telomere length with transplant outcomes to assess whether longer telomere length is associated with better long-term graft function and patient survival. METHODS: Telomere length (TL) was analysed in 274 European renal transplant pairs (donors/recipients). Recipient DNA was collected before and after kidney transplantation, and donor DNA just prior to transplant surgery. RESULTS: Donor TL was not significantly associated with graft survival. Donor age was a significant predictor of graft failure (1.02, 95% CI: 1.01-1.03, p < 0.01). Post-transplant recipient TL had a significant association with graft survival. Longer TL was associated with an up to 90% reduction in risk of graft failure (HR = 0.10, 95% CI: 0.015-0.71, p = 0.02). CONCLUSIONS: In this study, kidney transplant recipients with longer telomere length demonstrated significantly better long-term graft survival. If validated in additional kidney transplant cohorts, recipient telomere length could serve as a valuable biomarker for improving graft failure risk stratification and enhancing the long-term care of transplant recipients.