Urinary-Cell mRNA Profile and Acute Cellular Rejection in Kidney Allografts

Noninvasive means for diagnosing acute rejection in kidney transplants are needed. This study prospectively measured mRNA in urinary cells from kidney-allograft recipients. A three-gene signature appeared to be diagnostic and prognostic of acute cellular rejection. Kidney transplantation is considered the best available treatment for patients with end-stage renal disease (ESRD), but acute rejection, a leading cause of new cases of ESRD, undermines its full benefits. 1 – 3 Acute rejection is diagnosed by means of needle biopsy. Over time, this invasive procedure has become safer, and biopsy interpretation more standardized. 4 Nevertheless, bleeding and subsequent graft loss still occur, and sampling errors and interobserver variability in biopsy reading remain problematic. 5 Repeated biopsies to assess the recipient's status pose challenges, including feasibility and cost. Immunosuppressive drugs effectively treat acute rejection; a noninvasive means of diagnosing this reversible cause of . . .