Renal transplant rejection markers.
Acute rejection is one of the key factors which determine long-term graft function and survival in renal transplant patients. Timely detection and treatment of rejection is therefore, an important goal in the post-transplant surveillance. The standard care with serum creatinine measurements and biopsy upon allograft dysfunction implies that acute rejection is detected in an advanced stage. Therefore, non-invasive monitoring for acute rejection by markers in blood and urine has been tried over the past decades. This review describes the requirements that should be met by non-invasive markers. The experience with single biomarkers and with newer approaches--mRNA expression analysis, metabolomics, and proteomics--will be discussed, including future directions of necessary research.
Gwinner
Wilfried
W
Department of Internal Medicine, Division of Nephrology, Medical School Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. gwinner.wilfried@mh-hannover.de
D015415:Biomarkers / Q000652:urine; D006084:Graft Rejection / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D020411:Oligonucleotide Array Sequence Analysis; D020543:Proteome / Q000032:analysis / Q000235:genetics; D040901:Proteomics / Q000379:methods; D012680:Sensitivity and Specificity; D014556:Urine / Q000737:chemistry* / Q000502:physiology