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Nat Biomed Eng ; 4(6): 601-609, 2020 06.
Article in English | MEDLINE | ID: mdl-32284553

ABSTRACT

In organ transplantation, infection and rejection are major causes of graft loss. They are linked by the net state of immunosuppression. To diagnose and treat these conditions earlier, and to improve long-term patient outcomes, refined strategies for the monitoring of patients after graft transplantation are needed. Here, we show that a fast and inexpensive assay based on CRISPR-Cas13 accurately detects BK polyomavirus DNA and cytomegalovirus DNA from patient-derived blood and urine samples, as well as CXCL9 messenger RNA (a marker of graft rejection) at elevated levels in urine samples from patients experiencing acute kidney transplant rejection. The assay, which we adapted for lateral-flow readout, enables-via simple visualization-the post-transplantation monitoring of common opportunistic viral infections and of graft rejection, and should facilitate point-of-care post-transplantation monitoring.


Subject(s)
CRISPR-Cas Systems , Graft Rejection/virology , Opportunistic Infections/diagnosis , Pathology, Molecular/methods , Biomarkers/blood , Biomarkers/urine , Chemokine CXCL9/blood , Chemokine CXCL9/urine , Clustered Regularly Interspaced Short Palindromic Repeats , Cytomegalovirus/genetics , Cytomegalovirus/isolation & purification , Cytomegalovirus Infections/diagnosis , DNA, Viral/blood , DNA, Viral/genetics , DNA, Viral/urine , Humans , Kidney , Kidney Diseases/virology , Kidney Transplantation/adverse effects , Male , Middle Aged , Point-of-Care Testing , Polyomavirus/genetics , Polyomavirus/isolation & purification , Polyomavirus Infections/diagnosis , Postoperative Complications/diagnosis , RNA, Messenger , Tumor Virus Infections/diagnosis
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