Integrated Kidney Exosome Analysis for the Detection of Kidney Transplant Rejection

Jongmin Park, Hsing Ying Lin, Jean Pierre Assaker, Sangmoo Jeong, Chen Han Huang, Ahmed Kurdi, Kyungheon Lee, Kyle Fraser, Changwook Min, Siawosh Eskandari, Sujit Routray, Bakhos Tannous, Reza Abdi, Leonardo Riella, Anil Chandraker, Cesar M. Castro, Ralph Weissleder, Hakho Lee, Jamil R. Azzi

Research output: Contribution to journalArticlepeer-review

95 Scopus citations


Kidney transplant patients require life-long surveillance to detect allograft rejection. Repeated biopsy, albeit the clinical gold standard, is an invasive procedure with the risk of complications and comparatively high cost. Conversely, serum creatinine or urinary proteins are noninvasive alternatives but are late markers with low specificity. We report a urine-based platform to detect kidney transplant rejection. Termed iKEA (integrated kidney exosome analysis), the approach detects extracellular vesicles (EVs) released by immune cells into urine; we reasoned that T cells, attacking kidney allografts, would shed EVs, which in turn can be used as a surrogate marker for inflammation. We optimized iKEA to detect T-cell-derived EVs and implemented a portable sensing system. When applied to clinical urine samples, iKEA revealed high level of CD3-positive EVs in kidney rejection patients and achieved high detection accuracy (91.1%). Fast, noninvasive, and cost-effective, iKEA could offer new opportunities in managing transplant recipients, perhaps even in a home setting.

Original languageEnglish
Pages (from-to)11041-11046
Number of pages6
JournalACS Nano
Issue number11
StatePublished - 28 Nov 2017


  • acute cellular rejection
  • biosensor
  • kidney transplant
  • proteomics
  • urine exosomes


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