Biomarkers of rejection in kidney transplantation

Purpose of review To provide an update of the literature on the use of new biomarkers of rejection in kidney transplant recipients. Recent findings The kidney allograft biopsy is currently considered the gold standard for the diagnosis of rejection. However, the kidney biopsy is invasive and could be indeterminate. A significant progress has been made in discovery of new biomarkers of rejection, and some of them have been introduced recently for potential use in clinical practice including measurement of serum donor-derived cell free DNA, allo-specific CD154 thorn T-cytotoxic memory cells, and gene-expression 'signatures'. The literature supports that these biomarkers provide fair and reliable diagnostic accuracy and may be helpful in clinical decision-making when the kidney biopsy is contraindicated or is inconclusive. Summary The new biomarkers provide a promising approach to detect acute rejections in a noninvasive way.