“Transplantomics” for predicting allograft rejection: real-life applications and new strategies from Network Medicine

Monitoring of Serological, Cellular and Genomic Biomarkers in Transplantation, Computational Prediction Models and Role of Cell-Free DNA in Transplant Outcome

“…In recent years, the biomedical research community has attempted to respond by leveraging the power of omics platforms and generating big data, allowing for the measurement and analysis of large-scale molecular signatures from tissue biopsies and circulating cells [ 33 , 65 , 66 , 67 ]. Despite its small size, it can boast two predictive tests, the AlloMap [ 68 ] and AlloSure [ 69 ] assays, and other assays found in clinical trials, such as the Signatera TM and Prospera TM trials. Other novel noninvasive organ evaluation tools have recently been proposed, such as donor plasma mitochondrial DNA (mtDNA), which can be easily tested prior to transplantation and may be a promising predictive biomarker for delayed graft function (DGF) [ 70 ].…”

Novel insights in the clinical management of hyperimmune patients before and after transplantation

“…Indeed, the extensive immunization status precludes transplantation through regular assignment schemes for deceased donors, which are based on the exclusion of donor HLA-antigens to which the antibodies are directed (unacceptable antigens) ( Ziemann et al, 2022 ). The immunological barrier, which is linked both to an increased risk of antibody-mediated rejection and poor graft survival, remains a major deterrent to transplant ( Benincasa et al, 2022 ; Cozzi et al, 2017 ).…”

Epigenetics and outcome prediction in heart transplantation after circulatory death: A clinical perspective

“…Epigenetic mechanisms are being widely investigated in heart transplantation, serving as potential diagnostic and predictive biomarkers as well as targeted therapy. [4][5][6] Indeed, epigeneticsensitive signatures have the potential to reveal when and which molecular pathways trigger the host immune cells toward the graft and those pathways which determine how the graft reacts to early transplant stressors (e.g., cold ischemia time, donor aging), which together can affect the allograft survival/failure and its outcome (Figure 1). [4][5][6] One of the major gaps of the Donors after Circulatory Death Heart Trial is the absence of any focus on molecular biomarkers able to pre-…”