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Table 1 Laboratory-based biomarkers

From: Biomarkers in solid organ transplantation: establishing personalized transplantation medicine

  Organ Sample Proposed mechanism Biomarker References
(a) Pre-transplantation biomarkers
  Kidney, lung, liver Blood (DNA) Genetic variants in donor/recipient are associated with risk and severity of AR and with allograft survival 15 SNPs, TLR, C3 [3944, 46]
  Kidney Biopsy (mRNA) Expression profiles of innate immunity-related genes predict allograft survival C3 [47]
  Kidney Serum (protein); biopsy (mRNA) Novel immunogenic epitopes Non-HLA antigens [12, 4850]
(b) Post-transplantation biomarkers: acute allograft rejection
  Kidney Blood (PBMCs, mRNA), urine (mRNA) Cytotoxic proteins indicate AR FasL, GranzymeB, Perforine [27, 54, 57, 58]
  Kidney, lung, liver, heart Blood (PBMCs), serum, BALF, urine (mRNA, protein) Donor/recipient cytokine expression predicts/detects AR CXCR, CXCL10 CXCL9 [5963]
  Kidney Biopsy, blood (PBMCs, mRNA) Alterations in miRNA are associated with AR miR-142-5p, miR-155, miR-223 [6467]
  Kidney Biopsy Biomarkers for antibody-mediated rejection (diagnostic/predictive) CD38, endothelial cell genes [70, 71]
  Kidney Biopsy, serum (protein) Antibodies against novel non-HLA antigens (diagnostic/predictive) AT1R-AA, MICA, Duffy, Kidd, Agrin [50, 7275]
  Kidney, heart Biopsy, serum (mRNA, protein) Integrative proteogenomic biomarkers predict and diagnose AR across organs Novel non-HLA antigen PECAM1 [12, 76]
Post-transplantation biomarkers: chronic allograft damage
  Kidney Blood (mRNA), biopsy (mRNA), urine (mRNA) Predictive peripheral genes and proteins for mild/moderate chronic allograft damage and chronic antibody-mediated damage TRIB1, CCL2 [13, 77, 82]
  Kidney, heart Blood (protein), biopsy (mRNA), urine (protein) Early diagnostic peripheral and urinary gene expression for IF/TA and anti-fibrotic target KIM-1, CTGF [78, 79, 85, 86]
Post-transplantation biomarkers: graft accommodation
  Liver, kidney Blood (PBMCs, mRNA) Peripheral gene expression identifies transplant recipients for discontinuation of immunosuppression (a) Three classifiers of 2,3 and 7 genes; (b) 33-gene panel; (c) 343 genes [88, 89]
  Kidney Blood (mRNA) B-lymphocyte-related gene signature of tolerance in transplant patient PBMCs (a) B-cell signature
(IGKV1D-13, IGKV4-1, IGLL1);
(b) B-cell signature, ratio of FOXP3/α-1,2-mannosidase
[90, 91]
  1. AT1R-AA, agonistic antibodies against angiotensin type II receptor 1; BALF, bronchoalveolar fluid; CCL, CC chemokine ligand; FasL, Fas ligand; FOXP3, Forkhead box P3; IGKV, immunoglobulin kappa variable group; IGLL1, immunoglobulin lambda-like polypeptide 1; KIM-1, kidney injury molecule 1; TLR, Toll-like receptor; IF/TA, interstitial fibrosis/tubular atrophy.