Tracking kidney transplant fitness

An implantable bioelectronic device detects the early signs of kidney transplant rejection in rats Kidney transplantation (allograft) is a life-saving treatment for patients with end-stage kidney disease. Despite considerable progress over the past decades, improving long-term kidney allograft survival remains a major challenge with 10-year survival rates in the US of ∼55% for deceased donor transplants ( 1 ). Rejection, arising from the recipient's immune response to the allograft, accounted for ∼30% of graft loss ( 2 , 3 ). Therefore, early detection and management of rejection are crucial to prevent irreversible kidney tissue damage and enhance patient outcomes. On page 1105 of this issue, Madhvapathy et al . ( 4 ) describe a fully implantable, wireless, bioelectronic system to detect subclinical acute rejection. Using rat kidney transplantation models, the authors established that monitoring kidney temperature ( T kidney ) provides early warning of rejection with greater sensitivity than traditional biomarkers. This approach could uncover medication noncompliance and guide treatment to improve long-term graft outcomes.