Renal allografts inevitably develop progressive morphological and functional deterioration.
Naesens et al. now report on a transcriptomic approach to identify transcriptional markers
that might predict rapid development of chronic damage even in histologically unremarkable
allografts. The data indicate that similar processes as seen in overt acute rejection are also
involved in chronic allograft nephropathy. Identifying such “sub-morphological” markers
should help to better understand biological processes leading to chronic allograft failure.