title: Elaboration of gene expression-based clinical decision aids for kidney transplantation: where do we stand?
abstract: Successful kidney transplant management throughout the graft lifespan depends on adequate diagnosis (i.e., recognition of a particular type of graft rejection or injury) and prognosis (i.e., predicting future events or outcome). The currently used methods (mainly graft histology, immunosuppressive drug level monitoring, measurement of renal function, and DSA) have proven highly useful on a population level by indicating good or bad outcome, but are difficult to translate into meaningful tests for individual patients. There is thus a need for diagnostic and predictive tests that add value by being more informative to each patient, more powerful, addressing more specific questions or providing less invasive interventions. Gene expression profiling using microarrays or quantitative PCR has become a benchmark in research into novel and informative monitoring assays for transplantation. A wealth of gene expression studies are reported in the literature spanning two decades. There is now a need for clinical validation so that such tests can become standardized and approved for widespread integration into the standard of care to improve outcome for kidney transplant recipients.
authors.affiliation: INSERM, U643, Nantes, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Brouard
authors.forename: Magali
authors.initials: M
authors.lastname: Giral
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Soulillou
authors.forename: Joanna
authors.initials: J
authors.lastname: Ashton-Chess
mesh_terms: D000208:Acute Disease; D003661:Decision Support Techniques; D020869:Gene Expression Profiling; D006084:Graft Rejection; D006801:Humans; D016030:Kidney Transplantation; D011379:Prognosis