Biomarkers in renal transplantation: An updated review

Salvadori, Maurizio; Tsalouchos, Aris

doi:10.5500/wjt.v7.i3.161

Cited by 57 publications

(50 citation statements)

References 140 publications

(148 reference statements)

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“…Current biomarkers (i.e. lymphocyte subset analysis, neutrophil function assay, NK activation assay, cytokine production, etc…) have poor sensitivity and specificity, do not reveal slight changes of the immune system and, above all, none of them permit evaluation of the capability of the immune system to control infections 3 . Few immunological techniques are available to measure CMV-specific T-cell immunity and identify transplant recipients at risk of complicated CMV reactivation.…”

Section: Introductionmentioning

confidence: 99%

Early Post-Transplant Torquetenovirus Viremia Predicts Cytomegalovirus Reactivations In Solid Organ Transplant Recipients

Maggi

Focosi²,

Statzu

et al. 2018

Sci Rep

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Monitoring the human virome has been recently suggested as a promising and novel area of research for identifying new biomarkers which would help physicians in the management of transplant patients. Imbalance of the immune system in transplant recipients has a significant impact on replication of Torquetenovirus (TTV), the most representative and abundant virus of human virome. TTV kinetic was studied by real-time PCR in 280 liver or kidney transplant recipients who underwent different drug regimens to maintain immunosuppression. During one-year post-transplant follow-up, TTV viremia fluctuated irrespective of transplanted organ type but consistent with the immunosuppression regimen. TTV kinetic in patients who manifested cytomegalovirus (CMV) reactivation within the first four months post-transplant differed from that observed in patients who did not experience CMV complications. Importantly, plasma TTV load measured between day 0 and 10 post-transplant was significantly higher in CMV DNA positive than in CMV DNA negative patients. TTV viremia above 3.45 log DNA copies/ml within the first 10 days post-transplant correlates with higher propensity to CMV reactivation following transplantation. This study provides further evidence for using early post-transplant TTV viremia to predict CMV reactivation in liver or kidney transplant recipients.

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Section: Introductionmentioning

confidence: 99%

Early Post-Transplant Torquetenovirus Viremia Predicts Cytomegalovirus Reactivations In Solid Organ Transplant Recipients

Maggi

Focosi²,

Statzu

et al. 2018

Sci Rep

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“…Novel biomarkers such as genomic signatures either in the allograft, the peripheral blood, or other fluids also could be useful but would probably require more detailed validation as correlating with clinical endpoints such as graft survival. Several excellent recent reviews of biomarkers outline issues in this area …”

Section: Master Protocolsmentioning

confidence: 99%

The need for novel trial designs, master protocols, and research consortia in transplantation

Stegall

Smith

Bentall

et al. 2019

Clinical Transplantation

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Large multicenter, randomized controlled trials are the paradigm for determining the efficacy and safety of new therapies. However, applying this classical approach to many areas of transplantation is difficult. For most types of organ transplants, the number of transplants performed is too small for such a trial (lung, pancreas, or vascular composite transplantation are examples). In larger populations such as kidney transplantation, the major unmet needs commonly involve small subsets of patients (antibody-mediated rejection, recurrent renal disease, etc). This issue is not unique to transplantation and has been successfully overcome in other areas of medicine.In oncology, for example, novel trial designs such as adaptive trial design and master protocols are now relatively common. In addition, the existence of multicenter, ongoing clinical research consortia have greatly enhanced the successful implementation of these novel trial designs. In this manuscript, we examine how novel trial designs, master protocols, and research consortia might enhance studies in transplantation aimed at the regulatory approval of new agents. Our premise is that more efficient approaches to clinical trials already exist and, through a coordinated effort by researchers, the pharmaceutical industry, and regulatory bodies like the FDA, they can be implemented in transplantation.

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“…The cause of DGF is related to donor and recipient parameters such as ischemia-reperfusion injury, immunological response and immunosuppressive medications (6). The prevalence of DGF is signi cantly higher in deceased donor (5-50%) than live donor (4-10%) kidney transplant (7). Unfortunately there is no effective treatment for DGF, however early detection of DGF and intervention treatment may improve outcome.…”

Section: Introductionmentioning

confidence: 99%

The Predictive value of serum NGAL for the diagnosis of Delayed Graft Function in kidney transplantation

Pourmand

Emamjomeh

Gooran

et al. 2020

Preprint

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Background and aims the role of serum neutrophil gelatinase-associated lipocalin (NGAL) in predicting delayed graft function (DGF) after kidney transplantation is poorly defined. The objective of this study was to evaluate the serum NGAL expression in the early postoperative phase after kidney transplantation and compare it with serum creatinine (Cr). Methods We studied 32 patients who received kidney transplantation from deceased (n=24) and live (n=5) donors during October 2017 to December 2018 at the Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Serum NGAL, Serum Cr and urine output were measured at 1 to 7 day after transplantation. The need for dialysis in one week after transplantation was evaluated. Results Among 29 recipients with serum biomarkers measurements, 8 (27.5%) developed DGF (need to hemodialysis within 1 week of transplantation). Resulted in areas under ROC curves (AUCs) for serum NGAL at early hours following transplantation was (0.839, 95% CI: 0.69-0.98, P =0.005) that could accurately predict DGF compared to urine output (0.747, 95% CI: 0.55-0.93, P =0.045) and serum Cr (0.607, 95% CI: 0.34-0.86, P =0.398) at 24 hours after transplantation. Multivariate analysis revealed that only serum NGAL was significant independent predictor of DGF (OR: 0.996, 95% CI: 0.993-1.000, P =0.039). Conclusion Serum NGAL at early hours of post-transplantation was valuable biomarker for early accurate predictor of DGF in kidney transplantation compare with tradition biomarkers such as serum Cr and urine output.

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Biomarkers in renal transplantation: An updated review

Cited by 57 publications

References 140 publications

Early Post-Transplant Torquetenovirus Viremia Predicts Cytomegalovirus Reactivations In Solid Organ Transplant Recipients

Early Post-Transplant Torquetenovirus Viremia Predicts Cytomegalovirus Reactivations In Solid Organ Transplant Recipients

The need for novel trial designs, master protocols, and research consortia in transplantation

The Predictive value of serum NGAL for the diagnosis of Delayed Graft Function in kidney transplantation

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