Julie Ho1, David N Rush, Peter W Nickerson. 1. aSection of Nephrology, Department of Internal Medicine, University of Manitoba bManitoba Centre for Proteomics and Systems Biology, Health Sciences Centre cDepartment of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada.
Abstract
PURPOSE OF REVIEW: Renal allograft loss remains an important cause of morbidity and mortality. The objective of this review was to provide a rationale for noninvasive monitoring to identify patients at high risk for graft loss; discuss key steps in prognostic biomarker development from bench-to-bedside; and review promising biomarkers for late renal allograft outcomes. RECENT FINDINGS: In a multicentre prospective cohort, early 6-month urinary CCL2 was demonstrated to be associated with the development of 24-month interstitial fibrosis/tubular atrophy and inflammation (IFTA+i). These findings were extended to a single centre cohort, which showed that 6-month urinary CCL2 was a predictor of death-censored graft loss independent of donor-specific antibody and delayed graft function. In a large, multicentre prospective observational study (CTOT-01), 6-month urinary CXCL9 was significantly associated with more than 30% decline of graft function at 24 months. SUMMARY: Urinary chemokines may identify recipients who are at high risk of graft loss. The early detection of high-risk recipients may allow for more intensive posttransplant surveillance; avoidance of drug minimization/withdrawal protocols; and the identification of patients who may benefit from enrolment in novel interventional trials. Prospective trials are needed to demonstrate that urinary chemokine-guided posttransplant surveillance strategies improve long-term graft outcomes.
PURPOSE OF REVIEW: Renal allograft loss remains an important cause of morbidity and mortality. The objective of this review was to provide a rationale for noninvasive monitoring to identify patients at high risk for graft loss; discuss key steps in prognostic biomarker development from bench-to-bedside; and review promising biomarkers for late renal allograft outcomes. RECENT FINDINGS: In a multicentre prospective cohort, early 6-month urinary CCL2 was demonstrated to be associated with the development of 24-month interstitial fibrosis/tubular atrophy and inflammation (IFTA+i). These findings were extended to a single centre cohort, which showed that 6-month urinary CCL2 was a predictor of death-censored graft loss independent of donor-specific antibody and delayed graft function. In a large, multicentre prospective observational study (CTOT-01), 6-month urinary CXCL9 was significantly associated with more than 30% decline of graft function at 24 months. SUMMARY: Urinary chemokines may identify recipients who are at high risk of graft loss. The early detection of high-risk recipients may allow for more intensive posttransplant surveillance; avoidance of drug minimization/withdrawal protocols; and the identification of patients who may benefit from enrolment in novel interventional trials. Prospective trials are needed to demonstrate that urinary chemokine-guided posttransplant surveillance strategies improve long-term graft outcomes.
Authors: Martin Tepel; Subagini Nagarajah; Qais Saleh; Olivier Thaunat; Stephan J L Bakker; Jacob van den Born; Morten A Karsdal; Federica Genovese; Daniel G K Rasmussen Journal: Front Immunol Date: 2022-07-25 Impact factor: 8.786
Authors: Allison Tong; Klemens Budde; John Gill; Michelle A Josephson; Lorna Marson; Timothy L Pruett; Peter P Reese; David Rosenbloom; Lionel Rostaing; Anthony N Warrens; Germaine Wong; Jonathan C Craig; Sally Crowe; Tess Harris; Brenda Hemmelgarn; Braden Manns; Peter Tugwell; Wim Van Biesen; David C Wheeler; Wolfgang C Winkelmayer; Nicole Evangelidis; Benedicte Sautenet; Martin Howell; Jeremy R Chapman Journal: Transplant Direct Date: 2016-05-19
Authors: Nora Choi; Claudio Rigatto; Michael Zappitelli; Ang Gao; Simon Christie; Brett Hiebert; Rakesh C Arora; Julie Ho Journal: Can J Kidney Health Dis Date: 2018-01-24