Rejection Challenges: Diagnosis and Management

Lang, S; Riazy, Maziar; Blydt‐Hansen, Tom

doi:10.1007/978-3-030-74783-1_3

Cited by 1 publication

(2 citation statements)

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“…IFNγ stimulates renal tubular epithelial, mesangial, and infiltrating inflammatory cells to secrete the chemotactic cytokines (chemokines) CXCL9 and CXCL10, which in turn increase T cell recruitment to allograft via CXCR3 expressed on leukocytes. 75 Rabant et al 76 showed that urinary CXCL9/Cr ratio was associated with tubulointerstitial inflammation and TCR in adult kidney transplant recipients with an AUC of 0.90, while CXCL10/Cr ratio was associated with peritubular capillaritis and ABMR with an AUC of 0.82 for mixed rejection and 0.7 for ABMR alone. CXCL10/ Cr was found to be independently associated with graft loss (HR 2.2, 95% CI 1.4-2.2, p < .001), and patients who lost their graft because of ABMR had a higher ratio of CXCL10/Cr initially; thus, the ratio at the time of biopsy correlated with graft survival in a dose-dependent manner.…”

Section: Proteo MI C Smentioning

confidence: 99%

“…Rejection causes monocyte infiltration into the kidney tissue, leading to production of IFN‐γ. IFN‐γ stimulates renal tubular epithelial, mesangial, and infiltrating inflammatory cells to secrete the chemotactic cytokines (chemokines) CXCL9 and CXCL10, which in turn increase T cell recruitment to allograft via CXCR3 expressed on leukocytes 75 . Rabant et al 76 .…”

Section: Proteomicsmentioning

confidence: 99%

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Immune monitoring in pediatric kidney transplant

Laroche,

Engen

2024

Pediatric Transplantation

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BackgroundLong‐term outcomes in pediatric kidney transplantation remain suboptimal, largely related to chronic rejection. Creatinine is a late marker of renal injury, and more sensitive, early markers of allograft injury are an active area of current research.MethodsThis is an educational review summarizing existing strategies for monitoring for rejection in kidney transplant recipients.ResultsWe summarize supporting currently available clinical tests, including surveillance biopsy, donor specific antibodies, and donor‐derived cell free DNA, as well as the potential limitations of these studies. In addition, we review the current avenues of active research, including transcriptomics, proteomics, metabolomics, and torque tenovirus levels.ConclusionAdvancing the use of noninvasive immune monitoring will depend on well‐designed multicenter trials that include patients with stable graft function, include biopsy results on all patients, and can demonstrate both association with a patient‐relevant clinical endpoint such as graft survival or change in glomerular filtration rate and a potential timepoint for intervention.

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Section: Proteo MI C Smentioning

confidence: 99%

Section: Proteomicsmentioning

confidence: 99%