Biomarkers as Diagnostic and Predictive Tools in Transplantation: Discoveries at the Bench and Challenges to Bedside Integration

Abstract

Solid organ transplantation is a lifesaving procedure performed to treat a multitude of health conditions. Unfortunately, transplant rejection—an inflammatory response mediated by the recipient's immune system—remains a major and devastating challenge in the field. Because the individual transplant recipient possesses a very unique immunological landscape, much work has gone into making post-transplant care more personalized through the use of biomarkers that can herald rejection before it occurs or diagnose rejection more accurately than standard biopsy techniques. This review paper explores the intersection of science, health, and society with regard to the development of noninvasive and reliable biomarkers in transplantation. The paper examines 1) the motivation and need for biomarkers in transplantation, 2) advancements in high-throughput "omics" technology that have catalyzed recent biomarker discovery, and 3) the complex regulatory challenges in translating scientific discovery at the bench to patient care at the bedside. Through an analysis of the most recently published literature in the field, it becomes evident that the integration of biomarker technology into routine clinical care in transplantation will depend on the concerted efforts of many societal branches, including basic science researchers, technologists, clinicians, industry leaders, and regulatory agencies worldwide.