Current Status of Biomarkers and Molecular Diagnostic Tools for Rejection in Liver Transplantation: Light at the End of the Tunnel?

El Sabagh, Ahmed; Mohamed, Islam B; Aloor, Fuad Z; Abdelwahab, Ahmed; Hassan, Manal M; Jalal, Prasun K

El Sabagh, Ahmed; Mohamed, Islam B; Aloor, Fuad Z; Abdelwahab, Ahmed; Hassan, Manal M; Jalal, Prasun K.

Affiliation

El Sabagh A; Division of Gastroenterology, Baylor College of Medicine, Houston, TX, USA.
Mohamed IB; Department of Internal Medicine, Gastroenterology & Hepatology, Ain Shams University, Cairo, Egypt.
Aloor FZ; Division of Gastroenterology, Baylor College of Medicine, Houston, TX, USA.
Abdelwahab A; Department of Internal Medicine, Gastroenterology & Hepatology, Ain Shams University, Cairo, Egypt.
Hassan MM; Division of Gastroenterology, Baylor College of Medicine, Houston, TX, USA.
Jalal PK; Division of Gastroenterology, Baylor College of Medicine, Houston, TX, USA.

J Clin Exp Hepatol ; 13(1): 139-148, 2023.

Article in En | MEDLINE | ID: mdl-36647415

ABSTRACT

ABSTRACT

Strategies to minimize immune-suppressive medications after liver transplantation are limited by allograft rejection. Biopsy of liver is the current standard of care in diagnosing rejection. However, it adds to physical and economic burden to the patient and has diagnostic limitations. In this review, we aim to highlight the different biomarkers to predict and diagnose acute rejection. We also aim to explore recent advances in molecular diagnostics to improve the diagnostic yield of liver biopsies.

Key words

3BMBs, third bifurcation mucosal endo-bronchial biopsies; AMR, antibody mediated rejection; APC, antigen presenting cells; AR, Acute rejection; ATCMR, acute T-cell mediated rejection; ATG, Anti-thymoglobulin; AUC, area under curve; AUROC, area under receiver operating characteristic curve; B-HOT, Banff Human Organ Transplant; CNI, Calcineurin inhibitors; DSA, Donor specific antibodies; FDA, Food and drug administration; FFPE, formalin fixed paraffin embedded preparation; GLUT-4, glucose transport-4; HLA, human leukocyte antigens; HNMR, high nuclear magnetic resonance; ILTS, International liver transplantation society; LT, Liver transplantation; Liver transplantation; MDWG, molecular diagnostic work group; MFI, mean fluorescence intensity; MHC, major histocompatibility complex; MMDX; MMDX, Molecular microscopic diagnostic system; MMF, Mycophenolate Mofetil; MToR, Mechanistic target of Rapamycin; NPV, Negative predictive value; PPV, Positive predictive value; RATs, rejection associated transcripts; TBB, trans-bronchial biopsies; UNOS, United network for organ sharing and procurement; biomarker; dd cfDNA, donor-derived cell-free DNA; donor-derived cell-free DNA; immune-suppression; mRNA, messenger RNA; miRNA, micro-RNA; micro-RNA; molecular diagnosis; nano-string; rejection

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Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Diagnostic_studies / Prognostic_studies Language: En Journal: J Clin Exp Hepatol Year: 2023 Document type: Article Affiliation country: United States

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