How can we better protect a transplanted kidney?
Wroclaw Medical UniversityResearchers from Wroclaw Medical University investigated why some transplanted kidneys deteriorate despite treatment, focusing on a type of rejection called microvascular inflammation (MVI). This form of injury, now highlighted in the updated Banff 2022 Classification, is difficult to detect without biopsy and is often not accompanied by classic markers such as anti-HLA antibodies. To address this diagnostic gap, the team examined the role of non-HLA antibodies, particularly those targeting the angiotensin II type 1 receptor (AT1R).
In a study of 167 transplant recipients, MVI was significantly more common in patients with elevated AT1R antibody levels. Using advanced analytical methods, including artificial intelligence, the researchers identified that only high AT1R titers (>12 U/ml) meaningfully increased the risk of MVI. This suggests that non-HLA antibodies may contribute to graft injury in cases where traditional tests remain negative.
The findings open a path toward developing a more comprehensive, minimally invasive immunological profile to support early diagnosis of rejection. According to the authors, AI-assisted tools may become an essential part of transplant medicine, helping clinicians detect risk sooner and prolong the lifespan of transplanted kidneys.
- Journal
- Frontiers in Immunology