Molecular Mechanisms of Antibody-Mediated Rejection and Accommodation in Kidney Transplantation

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 31 July 2024 | Viewed by 2074

Special Issue Editors


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Guest Editor
Brigham and Women's Hospital, Boston, MA, USA
Interests: kidney transplant; chronic kidney disease; dialysis; acute kidney injury; pharmacoepidemiology
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Massachusetts General Hospital, Boston, MA, USA
Interests: kidney transplant; glomerular disease; glomerulonephritis; transplant immunology; COVID-19 immunology/vaccination

Special Issue Information

Dear colleagues,

Kidney transplantation is the ultimate treatment for end-stage kidney disease given better survival benefits and quality of life compared to dialysis. However, the process of kidney transplantation still faces numerous challenges, starting from organ allocation, recipient evaluation, immunosuppression, and post-transplant monitoring. Retrospectively, it has been an exciting moment for kidney transplant in the past decade. The outcomes of kidney transplantation have been improving as a result of numerous advances in research and discoveries – such as virtual crossmatching, development of non-invasive biomarkers, clinical trials for rejection treatment, prevention of recurrent glomerular disease, novel therapy for cytomegalovirus infection, and targeted cellular therapy for BK nephropathy.

We cordially invite authors and investigators to submit their original research, or review articles to this special issue, Molecular Mechanisms of Antibody-Mediated Rejection and Accommodation in Kidney Transplantation. This serves as an exceptional opportunity for all investigators to share their knowledge in the field of kidney transplantation to the medical community.

Dr. Panupong Hansrivijit
Dr. Ayman Al Jurdi
Guest Editors

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Keywords

  • kidney transplant
  • transplant immunology
  • recurrent glomerular disease
  • clinical trials
  • rejection
  • crossmatching
  • allocation
  • CMV
  • BK nephropathy

Published Papers (2 papers)

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22 pages, 3581 KiB  
Review
MicroRNAs as Potential Graft Rejection or Tolerance Biomarkers and Their Dilemma in Clinical Routines Behaving like Devilish, Angelic, or Frightening Elements
by Isabel Legaz, Víctor Jimenez-Coll, Rosana González-López, Marina Fernández-González, María José Alegría-Marcos, José Antonio Galián, Carmen Botella, Rosa Moya-Quiles, Manuel Muro-Pérez, Alfredo Minguela, Santiago Llorente and Manuel Muro
Biomedicines 2024, 12(1), 116; https://doi.org/10.3390/biomedicines12010116 - 5 Jan 2024
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Abstract
Allograft rejection is a widespread complication in allograft recipients with chronic kidney disease. Undertreatment of subclinical and clinical rejection and later post-transplant problems are caused by an imperfect understanding of the mechanisms at play and a lack of adequate diagnostic tools. Many different [...] Read more.
Allograft rejection is a widespread complication in allograft recipients with chronic kidney disease. Undertreatment of subclinical and clinical rejection and later post-transplant problems are caused by an imperfect understanding of the mechanisms at play and a lack of adequate diagnostic tools. Many different biomarkers have been analyzed and proposed to detect and monitor these crucial events in transplant outcomes. In this sense, microRNAs may help diagnose rejection or tolerance and indicate appropriate treatment, especially in patients with chronic allograft rejection. As key epigenetic regulators of physiological homeostasis, microRNAs have therapeutic potential and may indicate allograft tolerance or rejection. However, more evidence and clinical validation are indispensable before microRNAs are ready for clinical prime time. Full article
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8 pages, 1136 KiB  
Case Report
Molecular Microscope Diagnostic System in Patients after Kidney Transplantation—First Experience
by Monika Beliančinová, Patrícia Kleinová, Tímea Blichová, Matej Vnučák, Karol Graňák, Katarína Kajová Macháleková and Ivana Dedinská
Biomedicines 2024, 12(3), 548; https://doi.org/10.3390/biomedicines12030548 - 29 Feb 2024
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Abstract
Background: The diagnosis of graft rejection relies on the identification of donor-specific antibodies along with histological findings. Borderline changes are particularly challenging, representing non-rejection findings in up to 70% of cases. The analysis aimed to compare the results of histopathological conclusions with the [...] Read more.
Background: The diagnosis of graft rejection relies on the identification of donor-specific antibodies along with histological findings. Borderline changes are particularly challenging, representing non-rejection findings in up to 70% of cases. The analysis aimed to compare the results of histopathological conclusions with the findings from examination using a molecular microscope, which assesses gene expression (whole-genome microarray chip technology). Methods: Molecular microscope examination (MMDx) was applied to twelve patients (six men and six women) who underwent either indication or protocol graft biopsy. Results: The average age of patients was 46.6 years ± 4.2 (average follow-up from kidney transplantation was 6.1 months ± 1.2). MMDx examination was performed during indication biopsy in 11 patients and protocol biopsy in 1 patient. A total of 33% of the findings matched and 50% did not. Finally, we present a case of a patient with acute cellular rejection findings without clinical and laboratory correlation, where the use of MMDx significantly altered the treatment strategy. Conclusions: MMDx examination is suitable for complementing patients with ambiguous histological findings and a clinical picture not corresponding to biopsy results. The limitations of MMDx include cost and its inability to evaluate the potential recurrence of the underlying kidney disease in the graft. Full article
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