Urinary Test for Renal Allograft Rejection

Clinical assessment, routine monitoring, and noninvasive imaging of allograft function after renal transplant can be limited in accurately diagnosing individuals with acute rejection (AR) or other forms of injury because symptoms and signs poorly correlate with objective methods of assessing kidney allograft dysfunction. For management of AR, clinical signs and symptoms (eg, serum creatinine, glomerular filtration rate [GFR], and proteinuria) are relatively crude markers of renal dysfunction and occur late in the course of an exacerbation. Thus, noninvasive urine biomarkers have potential benefit in surveillance and management of renal allograft function. In transplant recipients, despite the progress in immunosuppressant therapy, the risk of rejection still remains. Diagnosis of allograft rejection continues to rely on clinical monitoring and histologic confirmation by tissue biopsy. However, due to limitations of tissue biopsy, including a high degree of interobserver variability in the grading of results and its potential complications, less invasive alternatives have been investigated. A laboratory developed test, One Lambda Laboratories CXCL10 assay, uses a noninvasive urine-based biomarker (CXCL10 protein) to support routine monitoring of graft dysfunction. One Lambda laboratories CXCL10 assay measures the concentration of the CXCL10/IP-10 protein within a urine sample.