14th National Congress of the Portuguese Society of Clinical Chemistry, Genetics and Laboratory Medicine

Immunologic monitoring KTxAlthough kidney transplantation constitutes the best treatment option for those with chronic kidney disease, the renal graft is subject to several threats and pathologies which can compromise its viability.These aggressions can be categorised as immunologic (like T cell or antibody mediated rejection) or nonimmunologic (hypertension, diabetes, or toxicity from immunosuppression).The medical follow-up of kidney transplant recipients has not changed much in the last decadeskidney function is evaluated through biochemical parameters (creatinine serum levels, calculated GFR, presence or absence of proteinuria), or even by histologic analysis of a kidney biopsy (considered the gold standard for a precise diagnosis).But all these methods have limitations and different aggressions may have the same phenotype.Furthermore, when serum creatinine rises, there has already been a significant loss of renal function.Therefore, there is urgent need for new methods that can precociously and accurately detect the cause of a kidney graft lesion before it becomes irreversible.In this presentation, the author summarises some of the new and/or most promising methods for an accurate diagnosis in kidney transplantation.These include the analysis of gene expression in the peripheral blood, the evaluation of cell free DNA from donor origin, or tests based on extracellular vesicles, which can be analysed either in blood or urine.The author hopes the liquid biopsy and precision medicine will be a part of our daily routine in following kidney transplant recipients in the near future and believes these new methods will help us all reach better outcomes for our patients.