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Updated: Jun 14, 2025

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Biomarkers in Kidney Transplantation.

Ashish Kataria1, Akshay Athreya2, Gaurav Gupta3

  • 1Division of Nephrology, Augusta Health, Georgia.

Advances in Kidney Disease and Health
|September 4, 2024
PubMed
Summary

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New biomarkers like donor-derived cell-free DNA can help nephrologists detect early kidney transplant injury. These tools offer improved monitoring beyond traditional markers for better patient care.

Area of Science:

  • Nephrology
  • Transplant Immunology
  • Biomarker Discovery

Background:

  • Over 250,000 patients in the US have functioning kidney allografts, with more added annually.
  • General nephrologists are increasingly involved in long-term kidney transplant recipient care.
  • Traditional biomarkers like serum creatinine and proteinuria are insufficient for detecting early allograft injury.

Purpose of the Study:

  • To review clinically available biomarkers for kidney transplant monitoring.
  • To highlight the utility of donor-derived cell-free DNA for early allograft injury detection.
  • To provide guidance for general nephrologists on implementing novel biomarkers.

Main Methods:

  • Review of current literature on kidney transplant biomarkers.
Keywords:
Acute RejectionAntibody mediated RejectionBiomarkersKidney transplantT-cell mediated Rejectiondonor-derived cell-free DNAnon-invasive

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  • Focus on donor-derived cell-free DNA, blood gene expression profiling, urinary biomarkers (mRNA, CXCL10), and Torque tenovirus.
  • Evaluation of biomarker utility for early detection of subclinical and acute rejection.

    • Main Results:

    • Donor-derived cell-free DNA shows promise for detecting early allograft injury.
    • Blood gene expression profiling requires further validation in multicenter trials.
    • Urinary mRNA and CXCL10 are potential early diagnostic markers for rejection.
    • Torque tenovirus levels may indicate the intensity of immunosuppression.

    Conclusions:

    • Novel biomarkers offer improved detection of kidney allograft dysfunction compared to traditional methods.
    • Implementation of these biomarkers can aid general nephrologists in managing transplant recipients.
    • Further research and validation are ongoing to refine the clinical application of these emerging tools.