Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Nov 6, 2015; 4(5): 487-491
Published online Nov 6, 2015. doi: 10.5527/wjn.v4.i5.487
Biomarkers in kidney transplantation: From bench to bedside
Natavudh Townamchai, Somchai Eiam-Ong
Natavudh Townamchai, Somchai Eiam-Ong, Division of Nephrology, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
Natavudh Townamchai, Center of Excellence in Solid Organ Transplantation, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
Author contributions: Townamchai N contributed to review the articles and write the manuscript; Eiam-Ong S contributed to design the manuscript topics and write the manuscript.
Conflict-of-interest statement: Authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Somchai Eiam-Ong, MD, Professor, Division of Nephrology, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Pathum Wan, Bangkok10330, Thailand. somchai80754@hotmail.com
Telephone: +662-256-4251
Received: May 28, 2015
Peer-review started: May 31, 2015
First decision: July 10, 2015
Revised: July 24, 2015
Accepted: September 10, 2015
Article in press: September 16, 2015
Published online: November 6, 2015

Immunosuppressive drug level monitoring and serum creatinine are widely used for kidney transplantation (KT) monitoring. Monitoring of drug level is not the direct measurement of the immune response while the rising of creatinine is too late for detection of allograft injury. Kidney biopsy, the gold standard for KT monitoring, is invasive and may lead to complications. Many biomarkers have been discovered for direct monitoring of the immune system in KT and the benefit of some biomarkers has reached clinical level. In order to use biomarkers for KT monitoring, physicians have to understand the biology including kinetics of each marker. This can guide biomarker selection for specific condition. Herein, we summarize the recent findings of donor specific anti-human leukocyte antigen antibody, B lymphocyte stimulator, interferon-gamma induced protein of 10 kDa, and intracellular adenosine triphosphate monitoring, all of which have very strong evidence support for the clinical use in KT.

Keywords: Kidney, Transplantation, Biomarkers, Donor specific antibody, B-cell, B lymphocyte stimulator, Interferon induced protein of 10 kDa, Intracellular adenosine triphosphate

Core tip: There are many studies about roles and benefits of biomarkers in nephrology, including transplantation. Only some of them reach the clinical level with strong evidence support. Biomarkers can guide immunosuppressive adjustment, provide prognostic value, and guide early detect of allograft injury, particularly from allograft rejection. We summarized the potential biomarkers for kidney transplantation monitoring, including clinical implication, strength and weakness of each of them.