Simultaneous liver-kidney transplantation: shifting renal allograft gene expression from inflammation toward preservation

Exposure of renal allografts to donor-specific antibodies activates many proinflammatory genes, resulting in antibody-mediated rejection. Simultaneous liver transplantation reduces the development of antibody-mediated rejection in renal grafts exposed to donor-specific antibodies. A study by Taner et al. in this issue of Kidney International shows this effect of the liver to involve more than simply absorbing donor-specific antibodies, with a shift in the pattern of gene expression in the kidney away from proinflammatory toward preservation of tissue function.