Non-invasive diagnosis of kidney allograft rejection
File(s)
Accepted version
Author(s)
Cardoso De Aguiar, Rute
Willicombe, Michelle
Roufosse, Candice
Type
Journal Article
Abstract
Despite regular conventional monitoring of kidney transplant recipients, allograft rejection remains a barrier for the long-term success of kidney transplantation and is one of the leading causes of graft failure. Kidney transplant rejection and graft failure are reported as the most feared outcomes by patients. Timely diagnosis of rejection and early treatment enable interventions which may attenuate alloimmune processes before irreversible graft injury has occurred. The evolving landscape of noninvasive diagnostic tools presents promising opportunities for early detection of kidney allograft rejection. These tools, alone or combined, may promptly signal the need for a biopsy, reduce the need for surveillance biopsies, or even potentially inform treatment monitoring. Therefore, they are of utmost importance, and their use should be informed by evidence, guiding both patients and their clinical teams. This review will cover noninvasive tests used for the diagnosis of kidney allograft rejection available or soon to be available in the clinical setting, and describe their diagnostic context, strengths and limitations, while proposing an ideal clinical framework for their use.
Date Issued
2025-11-01
Date Acceptance
2025-07-30
Citation
Journal of the American Society of Nephrology, 2025, 36 (11), pp.2269-2285
ISSN
1046-6673
Publisher
American Society of Nephrology
Start Page
2269
End Page
2285
Journal / Book Title
Journal of the American Society of Nephrology
Volume
36
Issue
11
Copyright Statement
Copyright © 2025 by the American Society of Nephrology. This is the author’s accepted manuscript made available under a CC-BY licence in accordance with Imperial’s Research Publications Open Access policy (www.imperial.ac.uk/oa-policy)
License URL
Publication Status
Published
Date Publish Online
2025-08-06