title: Establishing Biomarkers in Transplant Medicine: A Critical Review of Current Approaches.
abstract: Although the management of kidney transplant recipients has greatly improved over recent decades, the assessment of individual risks remains highly imperfect. Individualized strategies are necessary to recognize and prevent immune complications early and to fine-tune immunosuppression, with the overall goal to improve patient and graft outcomes. This review discusses current biomarkers and their limitations, and recent advancements in the field of noninvasive biomarker discovery. A wealth of noninvasive monitoring tools has been suggested that use easily accessible biological fluids such as urine and blood, allowing frequent and sequential assessments of recipient's immune status. This includes functional cell-based assays and the evaluation of molecular expression on a wide spectrum of platforms. Nevertheless, the translation and validation of exploratory findings and their implementation into standard clinical practice remain challenging. This requires dedicated prospective interventional trials demonstrating that the use of these biomarkers avoids invasive procedures and improves patient or transplant outcomes.
authors.affiliation: 1 Necker-Enfants Malades Institute, French National Institute of Health and Medical Research, Paris, France. 2 Paris Descartes, Sorbonne Paris Cité University, Paris, France. 3 Department of Nephrology and Kidney Transplantation, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. 4 KU Leuven-University of Leuven, Department of Microbiology and Immunology, Laboratory of Nephrology; University Hospitals Leuven, Department of Nephrology and Renal Transplantation, Leuven, Belgium. 5 CHU Limoges, Department of Nephrology, Dialysis and Transplantation, Limoges, France. 6 U850 INSERM, Univ. Limoges, CHU Limoges, Limoges, France. 7 Department of Nephrology, Hannover Medical School, Hannover, Germany.
authors.forename: Dany
authors.initials: D
authors.lastname: Anglicheau
authors.forename: Maarten
authors.initials: M
authors.lastname: Naesens
authors.forename: Marie
authors.initials: M
authors.lastname: Essig
authors.forename: Wilfried
authors.initials: W
authors.lastname: Gwinner
authors.forename: Pierre
authors.initials: P
authors.lastname: Marquet
mesh_terms: D064591:Allografts; D015415:Biomarkers / Q000032:analysis*; D006084:Graft Rejection / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation; D011507:Proteinuria / Q000175:diagnosis; D014019:Tissue Donors; D014181:Transplantation Immunology
chemical_list: D015415:Biomarkers