AUTHOR=Omić Haris , Eskandary Farsad , Beitzke Dietrich , Wolf Marcos , Kozakowski Nicolas , Böhmig Georg , Beck-Tölly Andrea , Eder Michael 

TITLE=T1 Relaxation Time for the Prediction of Renal Transplant Dysfunction

JOURNAL=Transplant International

VOLUME=Volume 38 - 2025

YEAR=2025

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2025.14301

DOI=10.3389/ti.2025.14301

ISSN=1432-2277

ABSTRACT=<p>Quantitative magnetic resonance imaging (MRI) is emerging as a non-invasive tool to measure tissue scarring in renal allografts. However, whether prolonged T<sub>1</sub> relaxation time results in lower transplant survival rates is unknown. This retrospective cohort study analyzed the capability to predict renal allograft dysfunction based on median T<sub>1</sub> time. Forty-six transplant recipients with non-contrast 1.5T MRI and allograft biopsy were included. The primary endpoint was the eGFR slope over 24 months. T<sub>1</sub> relaxation time correlated significantly with eGFR levels at all follow-up stages. Patients with T<sub>1</sub> relaxation time above the median (T<sub>1</sub><sup>high</sup>) had a consistent decline in kidney function as compared to the patient group below the median (T<sub>1</sub><sup>low</sup>): overall eGFR slope: 11.3 vs. 1.4 mL/min/1.73 m<sup>2</sup> over 24 months, p = 0.016. Graft survival rates at 24 months were 52% in the T<sub>1</sub><sup>high</sup> vs. 87% in the T<sub>1</sub><sup>low</sup> group, p = 0.0015. ROC analysis discovered a positive predictive value of 52% and a negative predictive value of 91% for graft loss. T<sub>1</sub> mapping identified patients with a persistent decline of allograft function and an increased risk of allograft loss. MRI could significantly influence monitoring strategies in transplant surveillance, offering a safe, non-invasive alternative to traditional diagnostic methods.</p>