Published online Mar 24, 2016. doi: 10.5500/wjt.v6.i1.28
Peer-review started: August 15, 2015
First decision: September 28, 2015
Revised: December 14, 2015
Accepted: January 5, 2016
Article in press: January 7, 2016
Published online: March 24, 2016
Rejection is one of the key factors that determine the long-term allograft function and survival in renal transplant patients. Reliable and timely diagnosis is important to treat rejection as early as possible. Allograft biopsies are not suitable for continuous monitoring of rejection. Thus, there is an unmet need for non-invasive methods to diagnose acute and chronic rejection. Proteomics in urine and blood samples has been explored for this purpose in 29 studies conducted since 2003. This review describes the different proteomic approaches and summarizes the results from the studies that examined proteomics for the rejection diagnoses. The potential limitations and open questions in establishing proteomic markers for rejection are discussed, including ongoing trials and future challenges to this topic.
Core tip: Timely detection and treatment of acute and chronic rejection is important to maintain the allograft function in renal transplant patients. Allograft biopsies are unsuitable for continuous monitoring for rejection. This review summarizes the past experience with proteomic approaches to diagnose rejection non-invasively. Potential limitations and open questions in establishing proteomic markers for rejection are discussed, including ongoing trials and future challenges to this topic.