Long Non Coding RNAs as Prognostic Factors or Diagnostic Biomarkers of Renal Transplant Rejection: A Systematic Review and Meta Analysis
Abstract
Purpose: Acute rejection (AR) of a kidney graft in renal transplant recipients is associated with microvascular injury leading to graft dysfunction and failure. Long noncoding RNAs (lncRNAs) may serve as markers for vascular injury and AR. We aimed to identify lncRNA biomarkers associated with graft loss after renal transplantation.
Materials and methods: We searched PubMed, Scopus, Embase, and Web of Science. Odds ratios (ORs), hazard ratios (HRs), and their 95% confidence intervals (95% CIs) were calculated to assess effect sizes. All graphical designs and statistical analyses were performed using STATA version 17 (StataCorp LP, College Station, TX, USA) and the meta package.
Results: Of 291 initially identified articles, 10 met eligibility criteria and were included in the systematic review; 3 provided sufficient data for meta‑analysis. The pooled area under the curve (AUC) for lncRNA measurement in diagnosing acute kidney rejection was 0.79 in adults and 0.75 in pediatric populations, indicating good diagnostic accuracy. Leave‑one‑out sensitivity analyses confirmed the stability of these findings. However, the pooled HR for the prognostic value of lncRNAs was 0.81 (95% CI: 0.63-1.04), which was not statistically significant.
Conclusion: Assessment of lncRNA levels in plasma or urine appears promising as a diagnostic biomarker for acute kidney rejection. The prognostic value of lncRNAs in the course of acute kidney rejection requires further evaluation.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 79 participants or records.
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