[en] Kidney transplantation (KTx) represents the best available treatment for patients with end-stage renal disease. Still, the full benefits of KTx are undermined by acute rejection (AR). The diagnosis of AR ultimately relies on transplant needle biopsy. However, such an invasive procedure is associated with a significant risk of complications and is limited by sampling error and interobserver variability. In the present review, we summarize the current literature about non-invasive approaches for the diagnosis of AR in kidney transplant recipients (KTRs), including in vivo imaging, gene-expression profiling and omics analyses of blood and urine samples. Most imaging techniques, such as contrast-enhanced ultrasound and magnetic resonance, exploit the fact that blood flow is significantly lowered in case of AR-induced inflammation. In addition, AR-associated recruitment of activated leucocytes may be detectable by 18F-fluorodeoxyglucose positron emission tomography. In parallel, urine biomarkers, including CXCL9/CXCL10 or a three-gene signature of CD3ε, CXCL10 and 18S RNA levels, have been identified. None of these approaches has yet been adopted in the clinical follow-up of KTRs, but standardization of analysis procedures may help assess reproducibility and comparative diagnostic yield in large, prospective, multicentre trials.
Disciplines :
Radiology, nuclear medicine & imaging Urology & nephrology
Author, co-author :
Erpicum, Pauline ; Université de Liège > Département des sciences cliniques > Néphrologie
HANSSEN, Oriane ; Centre Hospitalier Universitaire de Liège - CHU > Frais communs médecine - Pool assistants
WEEKERS, Laurent ; Centre Hospitalier Universitaire de Liège - CHU > Service de néphrologie
LOVINFOSSE, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de médecine nucléaire et imagerie onco
Meunier, Paul ; Université de Liège > Département des sciences cliniques > Département des sciences cliniques
TSHIBANDA, Luaba ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiodiagnostic
Krzesinski, Jean-Marie ; Université de Liège > Département des sciences cliniques > Néphrologie
Hustinx, Roland ; Université de Liège > Département des sciences cliniques > Médecine nucléaire
Jouret, François ; Université de Liège > Département des sciences cliniques > Néphrologie
Language :
English
Title :
Non-invasive approaches in the diagnosis of acute rejection in kidney transplant recipients, part II: omics analyses of urine and blood samples
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