Biomarkers for the diagnosis of acute cellular rejection in liver transplant recipients: A review

Abstract

The gold standard for the diagnosis of acute cellular rejection (ACR) is a liver biopsy. The quest for an alternative noninvasive biomarkers has been long and is ongoing. However, an efficient and useful biomarker has not been developed yet. In this manuscript, we review all possible candidate biomarkers that have been studied in recent years, starting with cytokines and ending with an overview of different newly discovered "omics". Promising paths are being explored but a valid non-invasive biomarker has not been discovered yet.

Red Blood Cell Distribution Width: A Novel Predictive Indicator for Cardiovascular and Cerebrovascular Diseases

“…Current diagnosis of CVDs mainly relies on clinical judgment, imaging manifestations, and some biochemical parameters, but indexes which could be routinely used in clinic are relatively finite [ 4 ]. Ideal diagnostic markers should be highly specific and sensitive, rapidly available, inexpensive, and noninvasive [ 5 ]. The clinicians have been attempting for years to seek such a biomarker to aid identification for early prevention, intervention, and therapy to prevent adverse cardiovascular and cerebrovascular events.…”

Usefulness of liver stiffness measurement during acute cellular rejection in liver transplantation

“…Although the setting of our study is completely different, it may be possible that a combination of noninvasive methods, including LSM and models such as the previously mentioned, could facilitate the management and treatment of ACR in liver transplant recipients: for example, in those patients with a high clinical suspect of rejection, with no other reasons to explain an increase in liver tests and in which noninvasive methods suggest mild rejection, an increase in baseline immunosuppression may be advised confidently. The expected development of more sophisticated and specific biomarkers using strategies such as proteomics or metabolomics may also contribute in the noninvasive assessment of liver rejection in the near future . In this regard, for example, the potential value of CD44 and CXCL9 in the prediction and diagnosis of clinically significant rejection has been recently proposed and should be further evaluated.…”

“…The expected development of more sophisticated and specific biomarkers using strategies such as proteomics or metabolomics may also contribute in the noninvasive assessment of liver rejection in the near future. 16 In this regard, for example, the potential value of CD44 and CXCL9 in the prediction and diagnosis of clinically significant rejection has been recently proposed 17 and should be further evaluated.…”

Biomarkers of immunosuppression

“…The ideal biomarker should be noninvasive or minimally invasive, rapidly available, sensitive, specific, and cost‐effective . Table lists the ideal properties and the common limitations in the identification of a suitable biomarker.…”