To provide an update of the literature on the use of new biomarkers of rejection in kidney transplant recipients.
The kidney allograft biopsy is currently considered the gold standard for the diagnosis of rejection. However, the kidney biopsy is invasive and could be indeterminate. A significant progress has been made in discovery of new biomarkers of rejection, and some of them have been introduced recently for potential use in clinical practice including measurement of serum donor-derived cell free DNA, allo-specific CD154 + T-cytotoxic memory cells, and gene-expression ‘signatures’. The literature supports that these biomarkers provide fair and reliable diagnostic accuracy and may be helpful in clinical decision-making when the kidney biopsy is contraindicated or is inconclusive.
The new biomarkers provide a promising approach to detect acute rejections in a noninvasive way.
aDivision of Nephrology and Hypertension
bDivision of Gastroenterology and Hepatology, Department of Internal Medicine, LSU Health Shreveport School of Medicine, Shreveport, Louisiana
cDivision of Transplant Surgery, University of Oklahoma, Oklahoma City, Oklahoma
dDivision of Nephrology, Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan, USA
Correspondence to Neeraj Singh, MD, MBA, FASN, FASH, FAST, Medical Director, Kidney and Pancreas Transplant, John C McDonald Regional Transplant Center, Shreveport, Louisiana, USA; Associate Professor of Internal Medicine, Division of Nephrology, Louisiana State University Health Sciences Center Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA. Tel: +1 318 675 7402; fax: +1 318 675 5913; e-mail: firstname.lastname@example.org