Physicians look for changes in the blood that indicate a problem in the transplanted organ, but the only way to confirm rejection is to perform a biopsy, she said. Sarwal is surveying thousands of human genes, searching for those that vary their activity in response to transplantation-associated changes in the immune system. Such changes can signal transplant rejection or problems caused by too much immunosuppression. Sarwal hopes to find a handful of genes that will reveal when rejection is occurring and what kind of rejection it is. Different kinds of rejection, said Sarwal, require different types of treatment.
Physicians first choose steroid drugs to treat the most common kind of rejection.
If the patient fails to improve, the doctor will switch to antibody therapy to stem rejection. So far, Sarwal and her colleagues have found more than 1,000 genes in normal cells that change their activity when organ rejection occurs. They hope to focus on five to 10 highly informative genes that will form the basis of a rapid blood test. Sarwal presented the team's initial findings as an invited speaker at the Rome meeting. More than a dozen Stanford faculty and residents presented research findings at the meeting.