Predicting an allograft's fate.

Renal allografts inevitably develop progressive morphological and functional deterioration. Naesens et al. now report on a transcriptomic approach to identify transcriptional markers that might predict rapid development of chronic damage even in histologically unremarkable allografts. The data indicate that processes similar to those seen in overt acute rejection are also involved in chronic allograft nephropathy. Identifying such 'sub-morphological' markers should help us to better understand biological processes leading to chronic allograft failure.