Understanding How Modern Diagnostics Support Your Transplant Journey

The field of organ transplantation today is at a pivotal moment. New technologies and diagnostics are emerging that can change how clinicians approach patient care and ultimately impact the overall quality of life for transplant recipients.

Testing plays a central role in the transplant journey. Human leukocyte antigen (HLA) labs and transplant teams need reliable diagnostic tools to provide personalized care at every stage. Every patient’s journey is unique, and understanding the role clinical diagnostics play can help patients and their caregivers know what to expect in the transplant journey.

Testing throughout the transplant journey

HLA typing is the gold standard in transplant diagnostics. Used alongside antibody screening, it determines compatibility between a patient and a donor in organ or stem cell transplantation. These tests answer the question of whether a patient’s immune system may reject the organ.

Before the time of transplant surgery, genotyping can determine how a patient may metabolize immunosuppressive medications, such as tacrolimus. Understanding a specific patient’s threshold for tacrolimus is important because all patients react differently. For example, patients may start out on a standard dose but adjust to the medication in drastically different ways. Knowing the insights from genotyping in advance can help teams set a more personalized starting dose, so fewer adjustments are needed later.

With more personalized immunosuppression approaches, patients can potentially reach better outcomes and take fewer medications, leading to a higher quality of life for transplant recipients.

After a transplant takes place, patients follow the monitoring protocol outlined by their transplant team, which is designed to catch organ rejection early if it happens. Maintaining the immunosuppression regimen and regular monitoring via blood testing for donor-specific antibodies, or DSAs, are part of a lifelong treatment plan.

Transplant diagnostics are evolving

Innovation in matching precision, immunosuppression management, and rejection monitoring doesn’t depend on the outcome of any single policy change, but rather on new developments from in vitro diagnostic companies with feedback from clinicians and laboratorians. Clinicians are already using higher-resolution assays and better predictive tools to assess rejection risk. In the future, AI may have the potential to extend those capabilities by delivering faster results and enhancing analysis efforts.

Pretransplant testing is where the field has changed most visibly. New tests enable a level of specificity that makes transplantation possible for patients who were once considered too immunologically sensitized to match. In fact, modern tests are able to help transplant care teams search for donors whose organs would sidestep certain antibodies in the recipient. For a patient who has spent years being told that there is no compatible donor, this change makes the difference between waiting indefinitely and being listed with a realistic chance of receiving an organ.

Immediately before surgery, virtual crossmatching has changed how quickly teams can evaluate an available organ. Virtual crossmatching can compare a patient’s HLA typing and antibody profile to donor data to predict compatibility, replacing the physical mixing of donor and recipient samples in a traditional, lab-based crossmatch. Speed matters most when an organ becomes available far away from a patient, and the window to accept or decline is narrow.

After a transplant, molecular biopsy testing gives clinicians a precise read on the health of a transplanted organ. It examines gene expression patterns within the tissue sample itself, helping teams distinguish between rejection and injury, which can look visually similar but require a different course of treatment. With the precise tools available today, care teams can understand that distinction earlier and start patients on the right treatment plan immediately. This earlier intervention may lead to better long-term outcomes for patients.

For patients, staying informed is a form of self-advocacy

With a deeper understanding of the transplant process, patients and their families can better advocate for their care and adjust to posttransplant regimens that stick. Tracking symptoms between visits and staying consistent with medication can make each appointment more productive and help ensure more positive outcomes.

Understanding the importance of diagnostic testing throughout the transplant journey can help reshape what recovery looks like. Testing does not end at surgery. Rather, it continues for as long as the transplant does, because the goal is not only for a patient to receive an organ, but for that organ to continue functioning within the body over time. Patients who understand what each test is looking to measure tend to find the process less intimidating and are better positioned to work with their care team throughout the rest of their transplant journey.

One of the biggest challenges for transplant care teams is determining whether a particular organ will work with a patient’s genetic and biological makeup. Transplant diagnostics can help answer that question, and patients who stay consistent with monitoring give their teams the information they need to protect their transplant over time.

Tina Liedtky has over 20 years of leadership experience in the medical device and diagnostics industry. As president of Transplant Diagnostics, Tina is responsible for the strategic direction and growth of Thermo Fisher Scientific’s transplant diagnostics portfolio across the patient care continuum. Previously, she served as president of Clinical Diagnostics, managing a broad portfolio of businesses within Thermo Fisher’s Specialty Diagnostics Group. Prior to joining Thermo Fisher, Tina led US and global commercial teams for the Diabetes Care and Rapid Diagnostics divisions of Abbott Laboratories, as well as sales and marketing leadership roles at Medtronic, Covidien and Boston Scientific.