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Updated: Jun 6, 2026

Mouse Kidney Transplantation: Models of Allograft Rejection

Mouse Kidney Transplantation: Models of Allograft Rejection

Published on: October 11, 2014

Rejection and function and chronic allograft dysfunction.

Johan W de Fijter¹

¹Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands. jwdefijter@lumc.nl

Kidney International. Supplement

|December 1, 2010

Summary

This summary is machine-generated.

Chronic allograft dysfunction is a major concern in kidney transplantation. Protocol biopsies may help identify patients at risk for late acute rejection when current biomarkers are unreliable.

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Last Updated: Jun 6, 2026

Mouse Kidney Transplantation: Models of Allograft Rejection

Mouse Kidney Transplantation: Models of Allograft Rejection

Published on: October 11, 2014

Area of Science:

Nephrology
Transplantation Immunology
Biomarker Research

Background:

Chronic allograft dysfunction is a significant challenge post-renal transplantation, despite reduced early acute rejection rates.
Factors like organ quality, ischemia/reperfusion injury, and acute rejection impact renal structure, leading to fibrosis and atrophy.
The prognostic significance of subclinical acute rejection and borderline changes remains debated, especially when excluding specific complicating factors.

Purpose of the Study:

To evaluate the utility of protocol biopsies in managing renal allograft dysfunction.
To address the limitations of current biomarkers for assessing renal function and immunosuppression.
To identify optimal strategies for patients at risk of late acute rejection.

Main Methods:

Review of current literature on renal transplantation outcomes and biomarkers.
Analysis of the role of protocol biopsies in detecting subclinical changes.
Discussion of the unreliability of serum creatinine and immunosuppressant trough levels.

Main Results:

Serum creatinine is an insensitive marker for glomerular filtration rate and renal damage.
Immunosuppressant trough level monitoring is unreliable for guiding drug dosing or exposure control.
Protocol biopsies may offer valuable insights into subclinical rejection and fibrosis.

Conclusions:

Current biomarkers (serum creatinine, trough levels) are insufficient for accurate assessment of renal function and immunosuppression.
Protocol biopsies are recommended for high-risk patients to detect potential late acute rejection.
Further research into sophisticated biomarkers is needed to guide immunosuppression effectively.