Abstract: Methods of assessing a graft recipient's predisposition to reject a transplant are provided. The risk of transplant rejection may be assessed in a subject prior to transplant, wherein subjects having a greater immune repertoire diversity prior to transplant are more susceptible to transplant rejection. Also, increases in immune repertoire diversity after transplant are indicative of transplant risk after. In another aspect, the presence or elevated abundance of immune elements comprising IGHV3-23 sequences are indicators of transplant rejection risk. In another aspect the scope of the invention encompasses methods of treating transplant rejection in a subject, by assessing transplant risk and administering immunosuppressive therapy in accordance with assessed risk.

Abstract: In the field of transplant rejection, identified are SNPs wherein mismatches in variants present in a recipient and donor for such SNPs are predictive of transplant outcome, wherein the SNPs represent non-HLA loci newly implicated in rejection. By the invention, transplant outcomes such as elevated risk of antibody mediated rejection, elevated risk of T-cell mediated rejection, or low risk of rejection can be predicted by analyzing mismatches between donor and recipient for the enumerated SNPs. Certain SNPs enumerated are predictive of kidney transplant outcome. The compatibility of prospective donors can be assessed for a recipient, allowing for optimized donor-recipient pairing.

Abstract: The disclosure describes a comprehensive metabolome analysis of urine samples that identified panels of metabolite markers for diagnosis and monitoring of alloimmune injury, acute rejection, and BK virus nephropathy. The disclosure provides non-invasive ways to monitor the status of transplanted kidneys by monitoring the presence of defined metabolite panels over a period of time. The metabolite panels of the disclosure can distinguish the between kidney injuries of distinct etiology with high sensitivity and specificity.

Abstract: Herein are novel methods of detecting subacute and active rejection in graft recipients, including kidney recipients by the measurement of donor-derived cell-free DNA. By the methods, active rejection processes encompassing T-cell mediated rejection may be detected. Also provided herein are novel threshold values for the determination of active rejection that enable higher sensitivity and specificity than prior methods. Additionally, by donor-derived cell-free DNA, subacute rejection processes can be detected, including borderline rejection and other graft injuries.

Abstract: Disclosed are novel methods of assessing transplant rejection status in a transplant recipient, such as a kidney transplant recipient. The diagnostic method identifies stable subjects, subjects undergoing cell mediated rejection processes, and subjects undergoing antibody mediated rejection processes using measurement of TCR subunit repertoire diversity. The proportion of unique TCR alpha and beta subunit sequences to total unique TCR subunit sequences (total sequences for alpha, beta, delta, and gamma subunits) provides a diagnostic measure that can identify stable subjects, subjects undergoing cell mediated rejection processes, and subjects undergoing antibody mediated rejection processes. Methods of treatment include administration of a suitable treatment if antibody mediated rejection or cell mediated rejection is detected.

Abstract: In the field of transplant rejection, identified are SNPs wherein mismatches in variants present in a recipient and donor for such SNPs are predictive of transplant outcome, wherein the SNPs represent non-HLA loci newly implicated in rejection. By the invention, transplant outcomes such as elevated risk of antibody mediated rejection, elevated risk of T-cell mediated rejection, or low risk of rejection can be predicted by analyzing mismatches between donor and recipient for the enumerated SNPs. Certain SNPs enumerated are predictive of kidney transplant outcome. The compatibility of prospective donors can be assessed for a recipient, allowing for optimized donor-recipient pairing.

Abstract: Provided herein are methods and compositions for the prediction and treatment of focal segmental glomerulosclerosis and oilier proteinuric renal diseases such as native FSGS, minimal change disease, glomerular nephritis, membrano-proliferative glomerular nephritis (membranous), or IgA glomerular nephritis (membranous).

Abstract: Provided herein are methods and compositions for the prediction and treatment of focal segmental glomerulosclerosis and other proteinuric renal diseases such as native FSGS, minimal change disease, glomerular nephritis, membrano-proliferative glomerular nephritis (membranous), or IgA glomerular nephritis (membranous).

Abstract: Methods of assessing a graft recipient's predisposition to reject a transplant are provided. The risk of transplant rejection may be assessed in a subject prior to transplant, wherein subjects having a greater immune repertoire diversity prior to transplant are more susceptible to transplant rejection. Also, increases in immune repertoire diversity after transplant are indicative of transplant risk after. In another aspect, the presence or elevated abundance of immune elements comprising IGHV3-23 sequences are indicators of transplant rejection risk. In another aspect the scope of the invention encompasses methods of treating transplant rejection in a subject, by assessing transplant risk and administering immunosuppressive therapy in accordance with assessed risk.

Abstract: Provided herein are methods and compositions for the prediction and treatment of focal segmental glomerulosclerosis and other proteinuric renal diseases such as native FSGS, minimal change disease, glomerular nephritis, membrano-proliferative glomerular nephritis (membranous), or IgA glomerular nephritis (membranous).

Abstract: Methods are provided for evaluating a subject for graft survival, e.g., in terms of predicting graft survival, identifying the presence of a deleterious graft condition, such as CAN and DT, identifying the severity and class of acute rejection, etc, in a subject are provided. In practicing the subject methods, the expression of at least one gene in a sample from the subject, e.g., a blood or biopsy sample, is assayed, e.g., at the nucleic acid and/or protein level, to evaluate the subject. Also provided are compositions, systems and kits that find use in practicing the subject methods. The methods and compositions find use in a variety of applications.