Patients can spend up to six years waiting for a kidney transplant. Even when they do receive a transplant, up to 20 percent of patients will experience rejection. Transplant rejection occurs when a recipient's immune cells recognize the newly received kidney as a foreign organ and refuse to accept the donor's antigens. Current methods for testing for kidney rejection include invasive biopsy procedures, causing patients to stay in the hospital for multiple days. A study by investigators from Exosome Diagnostics (https://www.exosomedx.com/) and Brigham and Women's Hospital proposes a new, noninvasive way to test for transplant rejection using exosomes--tiny vesicles that can contain mRNA--from urine samples. Their findings were published online on March 2, 2021 in the Journal of the American Society of Nephrology. The open-access article Is titled “Discovery and Validation of a Urinary Exosome mRNA Signature for the Diagnosis of Human Kidney Transplant Rejection” (https://jasn.asnjournals.org/content/early/2021/03/03/ASN.2020060850). "Our goal is to develop better tools to monitor patients without performing unnecessary biopsies. We try to detect rejection early, so we can treat it before scarring develops," said Jamil Azzi (photo), MD, Associate Physician in the Division of Renal Transplant at the Brigham and an Associate Professor of Medicine at Harvard Medical School. "If rejection is not treated, it can lead to scarring and complete kidney failure. Because of these problems, recipients can face life-long challenges." Before this study, physicians ordered biopsies or blood tests when they suspected that a transplant recipient was rejecting the donor organ. Biopsy procedures pose risks of complications, and 70-80 percent of biopsies end up being normal.
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