Improving Transplant Outcomes

The TGI approach to test development and management of transplant patient care is based on precision medicine. Precision medicine hinges on the ability to characterize individuals based on a wide range of molecular and phenotypic data—genomic, epigenomic, proteomic and other—that together convey a more accurate image of diagnosis that is personalized and multifaceted.

With respect to test development, we have taken an unbiased approach that is not hypothesis driven, but instead relies on interrogating the full complexity of the underlying biology. TGI’s objective is to discover robust molecular signatures indicative of individual patient graft status, prognosis or response to specific immunosuppressant regimens. Such information will complement existing immunohistological analysis, which is routinely performed yet often inconclusive, enabling precise patient-centric therapeutic intervention and improved transplant outcomes.

The figure above is a heat map representation of gene expression levels (red = high; blue = low) for 1,000 genes in 350 kidney biopsy samples from patients who were classified into diagnostic categories based on conventional histological analysis. The molecular phenotypes displayed show a strong correlation to graft status and offer the potential to complement histological analysis and resolve ambiguous or borderline results. Molecular signatures for each diagnostic category were discovered through an unbiased approach involving global gene expression studies. In the course of this research, more than 2,000 genes (including cellular receptors, cytokines and signaling molecules) were discovered that were differentially expressed in kidney biopsies and mapped back to over 60 distinct immunological pathways.

TGI’s extensive development pipeline includes diagnostic and predictive tests for kidney and liver graft dysfunction, the use of multiple sample types and technology platforms, companion diagnostics for immunosuppressants and immune status tests.