Clinical Transplantation Tolerance – a fingerprint?

Robert Lechler, King’s College London, London, UK

In the past decade, an explosion in the number of high-throughput tools for the measurement of different cellular products has occurred. These tools have the potential to further our understanding of human disease and this development has facilitated the identification of new biomarkers in all areas of medicine. In the field of solid organ transplantation, two different areas have developed: the use of biomarkers to predict allograft rejection, so that parenchymal damage can be prevented before it becomes irreversible and biomarkers for the identification of patients in whom donor-specific tolerance has developed. This ability would allow the minimization or even the withdrawal of immunosuppressive therapy in selected patients, thus reducing the number of adverse effects and costs, and optimizing long-term graft outcomes.

I will discuss the development of reliable and reproducible in vitro assays capable of detecting tolerance in renal transplant recipients. How several biomarkers and bioassays were screened on patient samples that included operationally tolerant renal transplant recipients, other recipient groups and healthy controls. These results have the potential to shape drug-weaning protocols in renal transplant recipients.