Novel Technology Has Made It Possible To Diagnose A New Clinical Phenotype Of Rejection called Early Antibody Mediated Rejection, With Significant Therapeutic Implications For Renal Allograft Survival

Abstract

Novel technology in transplant, specifically, the Molecular Microscope Diagnostic System, has made it possible to diagnose a new clinical phenotype of rejection called "early antibody-mediated rejection." Here, we present 2 kidney transplant recipients who had normal serum creatinine levels but elevated donor-derived cell-free DNA. Allograft biopsies did not show antibody-mediated rejection, but the Molecular Microscope Diagnostic System reported early antibody -mediated rejection. Once considered as an isolated incident occurring after kidney transplant, antibody-mediated rejection is now recognized to be a progressive condition that waxes and wanes over time and may ultimately lead to chronic allograft damage and allograft loss. Hence, if it can be diagnosed early before causing allograft injury, the early diagnosis can represent a paradigm shift in the management of antibody-mediated rejection in kidney transplant recipients, with better treatment outcomes and prolonged allograft survival.