ney transplant recipients using gene sets, or microarrays to identify AR signatures. These previous studies have allowed for a better understanding of the biology of transplant rejection. However, RNAseq is a new and superior method to identify DEGs and associated molecular cellular pathways since it is not limited to MedChemExpress JW-55 available probes, has increased sensitivity, and detects alternative splice variants, can detect low level expression PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19778579 and previously unknown transcripts. Most studies using microarrays showed gene expression changes at the time of a rejection event. However, other factors, such as the immunosuppression drug regimen, are also likely associated with changes in transcript expression. Most transplant centers reduce immunosuppression at 2 to 3 months post-transplant and it is likely that these changes in maintenance immune suppression alter expression. We report here gene expression changes in the blood of patients without AR or CGD; therefore the observed DEGs are not those associated with clinically PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19776034 evident rejection events. This analysis is the first step identifying gene signatures that correlate with favorable immune suppression. The ultimate goal is to identify an optimal immune genetic signature and ultimately personalize immunosuppressant drugs regimens to achieve that signature. Our hypothesis is that PBMC transcripts vary after the initiation of immunosuppression and at different times following kidney allograft transplantation. To identify these DEGs, we performed RNAseq analysis on PBMCs to identify gene expression patterns prior to transplant, 1 week, 3 months, and 6 months post-transplant in kidney allograft recipients. We identified DEGs that will further our understanding of the physiological, cellular and molecular 2 / 14 Differentially Expressed Genes after Kidney Transplant mechanisms of favorable immune suppression and kidney transplantation. Ideally, these expression patterns will lead to extending allograft survival and in turn improve the quality and longevity of kidney recipient lives. Methods Patients Thirty-two adults receiving living donor 
kidney allografts were studied. Patients received thymoglobulin induction and maintenance therapy with tacrolimus or cyclosporine, with mycophenolate and short course steroids to days 57 post-transplant. Four of the patients received tacrolimus or cyclosporine prior to transplantation. Five patients were receiving steroids and 9 were receiving mycophenolate at baseline for underlying disease. The subjects had no rejection or any previous rejection at time of each sample collection. Sequential whole blood samples for isolation of PBMCs were collected at baseline, week 1, month 3 and month 6 post-transplant. Some samples were not obtained because patients did not return to the transplant clinic for follow-up center visits and clinical follow ups were performed by referring physician. All patients in this study provided written informed consent following protocol that was approved by the institutional review board of the University of Minnesota. RNA Sequencing Blood was collected into BD Vacutainer EDTA coated tubes. RNA was isolated from approximately 12 mLs of whole blood PBMCs using the Qiagen QIAamp RNA Blood Mini kit within 2 hours of blood draw. RNA was quantitated with a Nanodrop 800 spectrophotometer. One g of each RNA sample was used to prepare RNAseq libraries based on the method as outlined by Zhong and colleagues with modifications and added quality checks.