No Extra Sticks, No Extra Burden: Building a Transplant Research Biobank Within Routine Care

Background: Biospecimen collections are essential to advance personalized care and biomarker discovery in kidney transplantation. However, logistical challenges often hinder implementation. We describe the development and early outcomes of a prospective transplant research biobank at a single academic center,highlighting feasibility,workflow integration, and specimen yield. Methods: Since January 2024, adult kidney transplant recipients undergoing clinically indicated biopsies or hospital admissions were screened for the Kidney Translational Research Center (KTRC)-Transplant Section. Patients were identified through daily biopsy schedules and inpatient list, then approached for consent. The process posed no added risk: blood was drawn during clinical sticks, urine collected non-invasively, and 5-10mm of tissue trimmed from standard care core specimens after retrieval and submitted for research/banking. No extra needle passes or cores were obtained. Prepared kits included EDTA tubes, serum tubes, RNA Paxgene tubes, urine containers, and cryotubes. Samples were processed into plasma, serum, urine, RNA, cell pellets, and OCT-embedded frozen tissue, then stored at –80°C. Materials were labeled with de-identified codes to ensure confidentiality. Data were captured using OpenSpecimen, a structured biospecimen system, with real-time entry, label printing, and clinical categorization. Coordination with nephrology, radiology, and nursing enabled seamless collection. Results: 31 patients were enrolled, with an estimated acceptance rate of ~80%. Collection was tailored to each case, with some contributing only blood or urine. In total, 293 biospecimens were archived, including 24frozen tissue samples,30cell pellets,75plasma aliquots,29RNA tubes,62serum aliquots, and72urine aliquots. All were processed and stored within protocol timelines. The biobank is already supporting translational studies on molecular rejection phenotypes. Conclusion: The KTRC Transplant biobank demonstrates that integrated, low-risk biospecimen collection in kidney transplant recipients is feasible and sustainable. Clinically aligned sampling and use of leftover tissue enabled high acceptance without added burden. Embedding biobanking into routine care offers a scalable model to accelerate discovery in transplant and nephrology.