Extracellular Vesicles: The Future of Diagnosis in Solid Organ Transplantation?

Abstract

Solid organ transplantation (SOT) is a life-saving treatment for end-stage organ failure, but it comes with several challenges, the most important of which is the existing gap between the need for transplants and organ availability. One of the main concerns in this regard is the lack of accurate non-invasive biomarkers to monitor the status of a transplanted organ. Extracellular vesicles (EVs) have recently emerged as a promising source of biomarkers for various diseases. In the context of SOT, EVs have been shown to be involved in the communication between donor and recipient cells and may carry valuable information about the function of an allograft. This has led to an increasing interest in exploring the use of EVs for the preoperative assessment of organs, early postoperative monitoring of graft function, or the diagnosis of rejection, infection, ischemia-reperfusion injury, or drug toxicity. In this review, we summarize recent evidence on the use of EVs as biomarkers for these conditions and discuss their applicability in the clinical setting.

Differentiation between lung allograft rejection and infection using donor-derived cell-free DNA and pathogen detection by metagenomic next-generation sequencing

“…In addition to dd-cfDNA, procalcitonin is also a promising plasma biomarker for posttransplant organ monitoring, showing good discriminating power for bacterial infections after heart and lung transplantation [ 29 , 30 ]. Extracellular vesicles are also under study as potential biomarkers of allograft rejection and immunity [ 31 , 32 ]. More invasive approaches like BALF analysis, which contains informative cytokines, remain a useful diagnostic method for pulmonary infections after lung transplantation [ 33 ].…”

Extracellular vesicles: a potential new player in antibody-mediated rejection in lung allograft recipients

“…Solid organ transplantation is the last option for patients with end-stage organ failure. Different groups have studied EVs in different solid organ transplant recipients to identify various biomarkers; this has been recently summarized by Garcia et al ( 82 ). The details of EVs as biomarkers in lung transplant recipients are provided in Table 2 .…”

Advances in Molecular Medicine: Unravelling Disease Complexity and Pioneering Precision Healthcare

“…The second review deals with solid organ transplantation (SOT) [ 2 ], a life-saving treatment for end-stage organ failure, but with demand for transplants exceeding organ availability. One major challenge is the lack of non-invasive biomarkers to monitor transplanted organs.…”