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Biomarkers in Kidney Transplantation

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Biomarkers in Kidney Disease

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Abstract

Kidney transplantation is the optimal renal replacement therapy. The progressions in immunosuppressive drugs improved the short-term survival, but 10-year graft survival is about 50 %, only. Acute or chronic rejection, drug nephrotoxicity, and transplant glomerulopathy all have adverse impacts on graft survival. Most of these events are the result of over- or under-immunosuppression.

On the other hand, tolerance as a state of no immunosuppression in the presence of functioning graft is an ultimate goal of transplantation.

In order to individualize treatments and recognize the optimal level of immunosuppression, noninvasive methods for diagnosis of acute rejection and tolerance have been developed, and biomarkers in the shade of technological advances would help physician in this way. Peripheral blood cell, plasma, and urine are readily accessible and perfect specimens for identification of biomarkers. This review is focused on recently developed biomarkers in acute rejection and tolerance as the two most important processes in decision-making about immunosuppressive therapy. The clinical utilities and limitations of these markers are discussed in details.

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Abbreviations

AR:

Acute rejection

ATI:

Acute tubular injury

ATN:

Acute tubular necrosis

AUC:

Area under the curve

BPAR:

Biopsy-proven acute rejection

CAD:

Chronic allograft dysfunction

CAMR:

Chronic antibody-mediated rejection

CE-MS:

Capillary electrophoresis mass spectrometry

CMV:

Cytomegalovirus

COT:

Clinical operational tolerance

Cr:

Creatinine

CXCL-10:

C-X-C motif chemokine 10

DGF:

Delayed graft function

eGFR:

Estimated glomerular filtration rate

ELISA:

Enzyme-linked immunosorbent assay

Foxp3:

Forkhead/winged helix transcription factor

IF/TA:

Interstitial fibrosis/tubular atrophy

IRI:

Ischemia-reperfusion injury

IS:

Immunosuppression

LC-MS:

Liquid chromatography-mass spectrometry

LC-MS/MS:

Liquid chromatography-tandem mass spectrometry

MMP-8:

Matrix metalloproteinase-8

NPV:

Negative predictive value

PBMC:

Peripheral blood mononuclear cell

PCR:

Polymerase chain reaction

PPV:

Positive predictive value

qPCR:

Quantitative polymerase chain reaction

RT-qPCR:

Real-time quantitative polymerase chain reaction

SELDI-TOF-MS:

Surface-enhanced laser desorption/ionization time-of-flight mass spectrometry

TCMR:

T-cell-mediated rejection

TG:

Transplant glomerulopathy

TOL:

Tolerance

Treg:

Regulatory T-cells

UMOD:

Uromodulin

UTI:

Urinary tract infection

VEGF:

Vascular endothelial growth factor

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Authors and Affiliations

  1. Department of nephrology, Labbafinejad medical center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mohsen Nafar & Shiva Samavat

  2. Chronic Kidney Disease Research Center (CKDRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mohsen Nafar & Shiva Samavat

Authors
  1. Mohsen Nafar
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  2. Shiva Samavat
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Correspondence to Shiva Samavat .

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Editors and Affiliations

  1. DeptofBiomedlSci,FacltyofSci&Technology, University of Westminster , London, United Kingdom

    Vinood B. Patel

  2. Department of Nutrition and Dietetics,Division of Diabetes and Nutritional Sciences, Faculty of Life Science and Medicine, King’s College London, London, United Kingdom

    Victor R. Preedy

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Nafar, M., Samavat, S. (2016). Biomarkers in Kidney Transplantation. In: Patel, V., Preedy, V. (eds) Biomarkers in Kidney Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7699-9_29

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