Virginia Commonwealth University
Kidney transplant rejection remains a significant challenge to long-term graft survival. While histological biopsy continues to be the gold standard for diagnosing rejection, noninvasive biomarkers such as donor-derived cell-free DNA (dd-cfDNA) have gained traction for their ability to detect allograft injury. However, dd-cfDNA may lack sensitivity in certain clinical scenarios particularly in cases of localized immune activation leading to false negatives despite biopsy-confirmed rejection.
One promising biomarker is CXCL10 (C-X-C motif chemokine ligand 10), a chemokine induced by interferon-γ that plays a central role in recruiting CXCR3+ T cells during immune responses. A 2021 study by Arnau et al. found that urinary CXCL10 levels were significantly associated with Banff scores of acute graft injury and donor-specific antibodies, and could discriminate both T-cell-mediated and antibody-mediated rejection in kidney transplant recipients, identifying CXCL10 as a promising candidate non-invasive biomarker for monitoring allograft rejection.
Prospective Inclusion Criteria: * Age ≥18 years * Undergoing a clinically indicated biopsy * Able to provide informed consent * Willing to provide a urine sample and allow access to relevant clinical Retrospective Inclusion Criteria: * Age ≥18 years * Biopsy-confirmed rejection (positive histology) * Donor-derived cell-free DNA\<1% result at time of biopsy * Availability of stored urine sample collected at time of biopsy Exclusion Criteria (applies to both arms): * Individuals under 18 years of age * Individuals unable to provide informed consent (for prospective enrollment) * Pregnant wo…
Subjects for this cohort will be selected from existing research database and criteria include: hx of kidney transplantation, clinically indicated biopsy, positive histology, \<1% circulating donor-derived cell-free DNA (dd-cfDNA) result at the time of biopsy, and Availability of frozen urine samples.
Subjects for this cohort will be selected based on ability to provide urine sample, recent kidney transplant recipient and underwent a clinically indicated biopsy
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