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New Markers for Transplant Rejection
- Source :
- Experimental and Clinical Transplantation. 18:1-9
- Publication Year :
- 2020
- Publisher :
- Baskent University, 2020.
-
Abstract
- Monitoring allograft function after kidney transplant has routinely relied on the use of nonspecific markers, such as serum creatinine, glomerular filtration rate, proteinuria, and donor-specific antibodies. These traditional markers have low sensitivity and fail to detect subclinical changes. Diagnosis of renal allograft dysfunction still requires an allograft biopsy, as it remains the criterion standard for assessment of graft status. However, renal biopsy is an invasive procedure, and sampling errors may result in misdiagnosis, perhaps causing graft failure. New biomarkers have been developed to monitor allograft function, although many are not yet routinely used. Other shortcomings, such as lack of standardization and high cost, should be solved before their widespread application in the clinic. A recipient's immune status could be monitored by use of urine or blood samples. These include functional cell-based assays and the evaluation of molecular expression at the messenger RNA or protein levels. Molecular technologies, including molecular microscope diagnostic systems, have been recently developed to improve the yield of histologic evaluation of the allograft biopsy. Prospective, interventional trials are required to demonstrate whether these new biomarkers improve patient or transplant outcomes. Implementation of these technologies into standard clinical practice remains challenging until their generalizability, cost, ease of interpretation, and the identification of patients who may benefit from more than standard-of-care surveillance can be determined. These biomarkers could allow immunosuppressive therapy to be individualized for patients.
- Subjects :
- Graft Rejection
Proteomics
medicine.medical_specialty
Clinical Decision-Making
Renal function
chemistry.chemical_compound
Isoantibodies
Monitoring, Immunologic
Predictive Value of Tests
medicine
Animals
Humans
Intensive care medicine
Subclinical infection
Transplantation
Creatinine
Immune status
Proteinuria
medicine.diagnostic_test
business.industry
Graft Survival
Sampling error
medicine.disease
Kidney Transplantation
Transplant rejection
Treatment Outcome
Molecular Diagnostic Techniques
chemistry
Renal biopsy
Chemokines
medicine.symptom
business
Cell-Free Nucleic Acids
Biomarkers
Immunosuppressive Agents
Subjects
Details
- ISSN :
- 21468427 and 13040855
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- Experimental and Clinical Transplantation
- Accession number :
- edsair.doi.dedup.....32f2b7c5daaa4d811055ee67ed1a48ff
- Full Text :
- https://doi.org/10.6002/ect.tond-tdtd2019.l6