Pretransplant characteristics of kidney transplant recipients that predict posttransplant outcome

Martin Tepel, Subagini Nagarajah, Qais Saleh, Olivier Thaunat, Stephan J L Bakker, Jacob van den Born, Morten A Karsdal, Federica Genovese, Daniel G K Rasmussen

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Better characterization of the potential kidney transplant recipient using novel biomarkers, for example, pretransplant plasma endotrophin, will lead to improved outcome after transplantation. This mini-review will focus on current knowledge about pretransplant recipients' characteristics, biomarkers, and immunology. Clinical characteristics of recipients including age, obesity, blood pressure, comorbidities, and estimated survival scores have been introduced for prediction of recipient and allograft survival. The pretransplant immunologic risk assessment include histocompatibility leukocyte antigens (HLAs), anti-HLA donor-specific antibodies, HLA-DQ mismatch, and non-HLA antibodies. Recently, there has been the hope that pretransplant determination of markers can further improve the prediction of posttransplant complications, both short-term and long-term outcomes including rejections, allograft loss, and mortality. Higher pretransplant plasma endotrophin levels were independently associated with posttransplant acute allograft injury in three prospective European cohorts. Elevated numbers of non-synonymous single-nucleotide polymorphism mismatch have been associated with increased allograft loss in a multivariable analysis. It is concluded that there is a need for integration of clinical characteristics and novel molecular and immunological markers to improve future transplant medicine to reach better diagnostic decisions tailored to the individual patient.

TidsskriftFrontiers in Immunology
Antal sider6
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
The funder had no role in the writing of the manuscript or the decision to submit it for publication. The funder had no role in data collection, analysis, or interpretation; trial design; patient recruitment; or any aspect pertinent to the study. There was no payment for writing this article by a pharmaceutical company or other agency. This study was supported by a grant from the European Union, Eurostars (Project E!12850 PRO-C6-Rec), Innovation Fund Denmark (Eurostars Project E!12850 PRO-C6-Rec and 9046-00025B, 2019), and the Danish Research Foundation.

Publisher Copyright:
Copyright © 2022 Tepel, Nagarajah, Saleh, Thaunat, Bakker, van den Born, Karsdal, Genovese and Rasmussen.


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