Noninvasive Methods to Assess the Risk of Kidney Transplant Rejection

Overview

Journal Expert Rev Clin Immunol

Specialty Allergy & Immunology

Date 2010 Feb 18

PMID 20161000

Citations 8

Authors

Paolo Cravedi

Roslyn B Mannon

Affiliations

Soon will be listed here.

Abstract

In current clinical practice, immune reactivity of kidney transplant recipients is estimated by monitoring the levels of immunosuppressive drugs, and by functional and/or histological evaluation of the allograft. The availability of assays that could directly quantify the extent of the recipient's immune response towards the allograft would help clinicians to customize the prescription of immunosuppressive drugs to individual patients. Importantly, these assays might provide a more in-depth understanding of the complex mechanisms of acute rejection, chronic injury, and tolerance in organ transplantation, allowing the design of new and potentially more effective strategies for the minimization of immunosuppression, or even for the induction of immunological tolerance. The purpose of this review is to summarize results from recent studies in this field.

Citing Articles

Follow-up biopsies with microvascular inflammation and persistent donor specific antibodies identify ongoing rejection in pediatric kidney transplant recipients.

Crane C, Mehrabli J, Ellington N, Shayan K, Morris G, Ingulli E Pediatr Nephrol. 2025; .

PMID: 39873804 DOI: 10.1007/s00467-025-06671-y.

Molecular immune monitoring in kidney transplant rejection: a state-of-the-art review.

Chancharoenthana W, Traitanon O, Leelahavanichkul A, Tasanarong A Front Immunol. 2023; 14:1206929.

PMID: 37675106 PMC: 10477600. DOI: 10.3389/fimmu.2023.1206929.

Relevant biomarkers of kidney allograft rejection.

Loga L, Dican L, Matei H, Maruntelu I, Constantinescu I J Med Life. 2022; 15(11):1330-1333.

PMID: 36567832 PMC: 9762359. DOI: 10.25122/jml-2022-0181.

Clinical Validation of an Immune Quiescence Gene Expression Signature in Kidney Transplantation.

Akalin E, Weir M, Bunnapradist S, Brennan D, Delos Santos R, Langone A Kidney360. 2022; 2(12):1998-2009.

PMID: 35419538 PMC: 8986041. DOI: 10.34067/KID.0005062021.

Thrombospondin-1, Platelet Factor 4, and Galectin-1 Are Associated with Engraftment in Patients with Sickle Cell Disease who Underwent Haploidentical Hematopoietic Stem Cell Transplantation.

Shaikh A, Olkhanud P, Gangaplara A, Kone A, Patel S, Gucek M Transplant Cell Ther. 2022; 28(5):249.e1-249.e13.

PMID: 35131485 PMC: 9176382. DOI: 10.1016/j.jtct.2022.01.027.

References

Vo A, Lukovsky M, Toyoda M, Wang J, Reinsmoen N, Lai C . Rituximab and intravenous immune globulin for desensitization during renal transplantation. N Engl J Med. 2008; 359(3):242-51. DOI: 10.1056/NEJMoa0707894. View

Muthukumar T, Ding R, Dadhania D, Medeiros M, Li B, Sharma V . Serine proteinase inhibitor-9, an endogenous blocker of granzyme B/perforin lytic pathway, is hyperexpressed during acute rejection of renal allografts. Transplantation. 2003; 75(9):1565-70. DOI: 10.1097/01.TP.0000058230.91518.2F. View

Cruzado J, Bestard O, Grinyo J . Control of anti-donor antibody production post-transplantation: conventional and novel immunosuppressive therapies. Contrib Nephrol. 2008; 162:117-28. DOI: 10.1159/000170844. View

Salama A, Remuzzi G, Harmon W, Sayegh M . Challenges to achieving clinical transplantation tolerance. J Clin Invest. 2001; 108(7):943-8. PMC: 200962. DOI: 10.1172/JCI14142. View

Schwarz A, Gwinner W, Hiss M, Radermacher J, Mengel M, Haller H . Safety and adequacy of renal transplant protocol biopsies. Am J Transplant. 2005; 5(8):1992-6. DOI: 10.1111/j.1600-6143.2005.00988.x. View

Mannon R, Hoffmann S, Kampen R, Cheng O, Kleiner D, Ryschkewitsch C . Molecular evaluation of BK polyomavirus nephropathy. Am J Transplant. 2005; 5(12):2883-93. DOI: 10.1111/j.1600-6143.2005.01096.x. View

Cattell E, Cunningham A, Bal W, Taylor R, Dark J, Kirby J . Limiting dilution analysis: quantification of IL-2 producing allospecific lymphocytes after renal and cardiac transplantation. Transpl Immunol. 1994; 2(4):300-7. DOI: 10.1016/0966-3274(94)90006-x. View

Najafian N, Salama A, Fedoseyeva E, Benichou G, Sayegh M . Enzyme-linked immunosorbent spot assay analysis of peripheral blood lymphocyte reactivity to donor HLA-DR peptides: potential novel assay for prediction of outcomes for renal transplant recipients. J Am Soc Nephrol. 2001; 13(1):252-259. DOI: 10.1681/ASN.V131252. View

Grebe S, Mueller T . Immune monitoring in organ transplantation using neopterin. Curr Drug Metab. 2002; 3(2):189-202. DOI: 10.2174/1389200024605109. View

10.

Rodrigo E, Arias M . A practical approach to immune monitoring in kidney transplantation. Minerva Urol Nefrol. 2007; 59(3):337-52. View

11.

Kowalski R, Post D, Mannon R, Sebastian A, Wright H, Sigle G . Assessing relative risks of infection and rejection: a meta-analysis using an immune function assay. Transplantation. 2006; 82(5):663-8. DOI: 10.1097/01.tp.0000234837.02126.70. View

12.

Pearl J, Parris J, Hale D, Hoffmann S, Bernstein W, McCoy K . Immunocompetent T-cells with a memory-like phenotype are the dominant cell type following antibody-mediated T-cell depletion. Am J Transplant. 2005; 5(3):465-74. DOI: 10.1111/j.1600-6143.2005.00759.x. View

13.

Sawitzki B, Bushell A, Steger U, Jones N, Risch K, Siepert A . Identification of gene markers for the prediction of allograft rejection or permanent acceptance. Am J Transplant. 2007; 7(5):1091-102. DOI: 10.1111/j.1600-6143.2007.01768.x. View

14.

Grimm P, McKenna R, Nickerson P, Russell M, Gough J, Gospodarek E . Clinical rejection is distinguished from subclinical rejection by increased infiltration by a population of activated macrophages. J Am Soc Nephrol. 1999; 10(7):1582-9. DOI: 10.1681/ASN.V1071582. View

15.

Hirsch H, Brennan D, Drachenberg C, Ginevri F, Gordon J, Limaye A . Polyomavirus-associated nephropathy in renal transplantation: interdisciplinary analyses and recommendations. Transplantation. 2005; 79(10):1277-86. DOI: 10.1097/01.tp.0000156165.83160.09. View

16.

. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther. 2001; 69(3):89-95. DOI: 10.1067/mcp.2001.113989. View

17.

Najafian N, Albin M, Newell K . How can we measure immunologic tolerance in humans?. J Am Soc Nephrol. 2006; 17(10):2652-63. DOI: 10.1681/ASN.2005070707. View

18.

Heinemann F, Rebmann V, Witzke O, Philipp T, Broelsch C, Grosse-Wilde H . Association of elevated pretransplant sCD30 levels with graft loss in 206 patients treated with modern immunosuppressive therapies after renal transplantation. Transplantation. 2007; 83(6):706-11. DOI: 10.1097/01.tp.0000255326.27474.a4. View

19.

Korczak-Kowalska G, Wierzbicki P, Bocian K, Klosowska D, Niemczyk M, Wyzgal J . The influence of immuosuppressive therapy on the development of CD4+CD25+ T cells after renal transplantation. Transplant Proc. 2007; 39(9):2721-3. DOI: 10.1016/j.transproceed.2007.09.015. View

20.

Tatapudi R, Muthukumar T, Dadhania D, Ding R, Li B, Sharma V . Noninvasive detection of renal allograft inflammation by measurements of mRNA for IP-10 and CXCR3 in urine. Kidney Int. 2004; 65(6):2390-7. DOI: 10.1111/j.1523-1755.2004.00663.x. View