Detecting the Likelihood of Kidney Transplant Rejection with Non-invasive Urine Test¹

Invasive biopsy procedures, which may require patients to stay in the hospital for several days, are the current approaches for testing kidney rejection. Urinary exosomes, the tiny vesicles containing mRNA, are found to be a potential noninvasive diagnostic biomarker for kidney-transplant rejection. In a study, 192 urine samples with matched biopsy samples involving 175 patients, who underwent a clinically indicated kidney-transplant biopsy, were collected. The urinary exosomal mRNAs were isolated from the immune cells of the newly transplant kidneys. A rejection signature with a group of 15 genes, which could distinguish between normal kidney function and rejection was identified. It is also noteworthy that five genes, which could differentiate two types of rejection: cellular rejection and antibody-mediated rejection, were recognised. As the mRNA signatures derived from urinary exosomes can represent a powerful and noninvasive tool to screen for kidney allograft rejection, it holds promise to assist clinicians in therapeutic decision making.

References

1. El Fekih R, et al. J Am Soc Nephrol. 2021;ASN.2020060850.