Monitoring Kidney Transplants
More than 15,000 patients receive lifesaving kidney transplants in the United States each year, and kidney transplantation is the treatment of choice for many end-stage kidney diseases. Complications due to rejection and infection limit its long-term benefits. While clinicians strive to monitor transplant patients carefully, diagnostic options remain limited. Diagnosis of rejection, for example, requires an invasive needle biopsy. Tests for diagnosing infection are predominantly limited to one pathogen at a time, which is prohibitively time-consuming and costly.
Iwijn De Vlaminck, Meinig School of Biomedical Engineering, is proposing radically new precision-medicine approaches to kidney transplant monitoring. His team is inventing and applying genomic assays with single-cell and single-molecule resolution to dissect the complex molecular and cellular heterogeneity associated with important immunological and infectious post-transplant complications. Analyses are being performed on hundreds of urine samples collected from a cohort of kidney transplant recipients, available through collaboration with Manikkam Suthanthiran, Nephrology and Hypertension, Weill Cornell Medicine.
The team is developing and implementing high-throughput, single-cell sequencing of isolated cells to understand, predict, and diagnose kidney transplant complications. They are also inventing and testing noninvasive diagnostic strategies that track small fragments of DNA, from the debris of dead cells, found in the urine. These fragments could be used as markers to identify and quantify injury associated with kidney transplant complications and to profile the urinary microbiome associated with infection and rejection. Successful implementation of these studies will illuminate the biology of post-transplant complications with unprecedented resolution and will lead to novel, noninvasive liquid biopsies to monitor the health of transplanted kidneys.