Molecular diagnostics in renal allograft biopsy interpretation: potential and pitfalls

Application of molecular techniques, particularly gene expression microarrays, to the study of T cell-mediated rejection, antibody-mediated rejection (ABMR), and other changes in renal allografts has grown. While studies of gene expression within renal allograft biopsies have elucidated the pathogenesis of rejection and helped lead to recognition of C4d-negative ABMR, the use of molecular studies to achieve greater diagnostic accuracy and precision, guide therapy, and decrease the need for biopsies still remains a hope for the future.