June 21, 2013

Molecular Diagnosis of Antibody-Mediated Rejection in Human Kidney Transplants


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The diagnosis of late antibody-mediated rejection (AbMR) by conventional methods can be inaccurate due to the high degree of variability in the histologic lesions and the guidelines used to interpret such lesions. In the study by Sellares et. al. a gene expression based classifier was developed to assign the probability of AbMR to each biopsy (N=405 biopsies from 315 patients). The classifier scores showed good correlation with the presence of microcirculation inflammation and donor-specific antibody. When biopsy scores were compared between three pathologists, the classifier scores also associated with likelihood that a biopsy would be diagnosed as AbMR by all pathologists. Thus, gene expression classifier analysis may prove useful in guiding histopathology scoring and narrow the discrepancies between histology-based diagnoses of AbMR.

Renal Transplantation

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