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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+Kidney+J
2017 ; 10
(1
): 97-105
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Non-invasive approaches in the diagnosis of acute rejection in kidney transplant
recipients Part I In vivo imaging methods
#MMPMID28643821
Hanssen O
; Erpicum P
; Lovinfosse P
; Meunier P
; Weekers L
; Tshibanda L
; Krzesinski JM
; Hustinx R
; Jouret F
Clin Kidney J
2017[Feb]; 10
(1
): 97-105
PMID28643821
show ga
Kidney transplantation (KTx) represents the best available treatment for patients
with end-stage renal disease. Still, 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, like 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 leukocytes may be detectable by (18)F-fluoro-deoxy-glucose positron
emission tomography. In parallel, urine biomarkers, including CXCL9/CXCL10 or a
three-gene signature of CD3?, IP-10 and 18S RNA levels, have been identified.
None of these approaches has been adopted yet in the clinical follow-up of KTRs,
but standardization of procedures may help assess reproducibility and compare
diagnostic yields in large prospective multicentric trials.
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