MOLECULAR DIAGNOSTICS CAN FILL THE GAPS
There is an urgent need for noninvasive, personalized, precision diagnostics that enable effective monitoring of organ transplant recipients. The gaps left by histological assessment and late-emerging biomarkers of allograft injury provide an ideal opportunity to integrate molecular assays into the transplant diagnostic paradigm with the aim of reducing costs, extending graft survival, and improving patient quality of life.
Although the limitations of the novel assays discussed in this article preclude their adoption as complete replacements for histology, the concomitant use of conventional histopathology, antibody testing, and molecular-based assays appears to offer significant benefits for improving solid organ transplant outcomes.
As molecular approaches gain momentum, machine-learning based algorithms likely will have greater utility than single biomarkers alone, driving the integration of data from various diagnostic platforms and requiring more frequent, interdisciplinary communication between the clinician and the laboratory.
Though greater engagement with government agencies is needed to expand market access and reimbursement, we are on the precipice of a massive shift in the transplant diagnostic paradigm. This will be exciting to witness because it has the potential to augment care, transform therapy, and improve patient survival.
