{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:22:28Z","timestamp":1788355348237,"version":"build-2803163510"},"reference-count":72,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T00:00:00Z","timestamp":1595376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Despite new advancements in surgical tools and therapies, exposure to immunosuppressive drugs related to non-immune and immune injuries can cause slow deterioration and premature failure of organ transplants. Diagnosis of these injuries by non-invasive urine monitoring would be a significant clinical advancement for patient management, especially in pediatric cohorts. We investigated the metabolomic profiles of biopsy matched urine samples from 310 unique kidney transplant recipients using gas chromatography\u2013mass spectrometry (GC-MS). Focused metabolite panels were identified that could detect biopsy confirmed acute rejection with 92.9% sensitivity and 96.3% specificity (11 metabolites) and could differentiate BK viral nephritis (BKVN) from acute rejection with 88.9% sensitivity and 94.8% specificity (4 metabolites). Overall, targeted metabolomic analyses of biopsy-matched urine samples enabled the generation of refined metabolite panels that non-invasively detect graft injury phenotypes with high confidence. These urine biomarkers can be rapidly assessed for non-invasive diagnosis of specific transplant injuries, opening the window for precision transplant medicine.<\/jats:p>","DOI":"10.3390\/jcm9082341","type":"journal-article","created":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T11:26:01Z","timestamp":1595503561000},"page":"2341","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Targeted Urine Metabolomics for Monitoring Renal Allograft Injury and Immunosuppression in Pediatric Patients"],"prefix":"10.3390","volume":"9","author":[{"given":"Tara K.","family":"Sigdel","sequence":"first","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew W.","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2410-7817","authenticated-orcid":false,"given":"Joshua Y. C.","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reuben D.","family":"Sarwal","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1927-5058","authenticated-orcid":false,"given":"Juliane M.","family":"Liberto","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minnie M.","family":"Sarwal","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"471","DOI":"10.2215\/CJN.05021107","article-title":"Kidney transplantation as primary therapy for end-stage renal disease: A National Kidney Foundation\/Kidney Disease Outcomes Quality Initiative (NKF\/KDOQITM) conference","volume":"3","author":"Abecassis","year":"2008","journal-title":"Clin. J. Am. Soc. Nephrol. CJASN"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1111\/j.1600-6143.2007.02146.x","article-title":"Solving the organ shortage crisis: The 7th annual American Society of Transplant Surgeons\u2019 State-of-the-Art Winter Symposium","volume":"8","author":"Pomfret","year":"2008","journal-title":"Am. J. Transplant."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1111\/j.1600-6143.2004.00332.x","article-title":"Lack of improvement in renal allograft survival despite a marked decrease in acute rejection rates over the most recent era","volume":"4","author":"Schold","year":"2004","journal-title":"Am. J. Transplant."},{"key":"ref_4","first-page":"350","article-title":"Improving Long-Term Outcomes in Kidney Transplantation: Towards a New Paradigm of Post-Transplant Care in the United States","volume":"127","author":"Gaston","year":"2016","journal-title":"Trans. Am. Clin. Climatol. Assoc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1080\/14737159.2016.1239530","article-title":"Advances in diagnostics for transplant rejection","volume":"16","author":"Nasr","year":"2016","journal-title":"Expert Rev. Mol. Diagn."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1111\/ajt.14107","article-title":"The Banff 2015 Kidney Meeting Report: Current Challenges in Rejection Classification and Prospects for Adopting Molecular Pathology","volume":"17","author":"Loupy","year":"2017","journal-title":"Am. J. Transplant."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1097\/FTD.0b013e31816ba73a","article-title":"Pharmacokinetics of mycophenolate mofetil and sirolimus in children","volume":"30","author":"Filler","year":"2008","journal-title":"Ther. Drug Monit."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1038\/nrg.2017.12","article-title":"Transplant genetics and genomics","volume":"18","author":"Yang","year":"2017","journal-title":"Nat. Rev. Genet."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1172\/jci.insight.94197","article-title":"The MMDx-Kidney Study Group. Assessing rejection-related disease in kidney transplant biopsies based on archetypal analysis of molecular phenotypes","volume":"2","author":"Reeve","year":"2017","journal-title":"JCI Insight"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Roedder, S., Sigdel, T., Salomonis, N., Hsieh, S., Dai, H., Bestard, O., Metes, D., Zeevi, A., Gritsh, A., and Cheeseman, J. (2014). The kSORT assay to detect renal transplant patients at high risk for acute rejection: Results of the multicenter AART study. PLoS Med., 11.","DOI":"10.1371\/journal.pmed.1001759"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1074\/mcp.M113.030577","article-title":"The identification of novel potential injury mechanisms and candidate biomarkers in renal allograft rejection by quantitative proteomics","volume":"13","author":"Sigdel","year":"2014","journal-title":"Mol. Cell. Proteom. MCP"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.1084\/jem.20122709","article-title":"A common rejection module (CRM) for acute rejection across multiple organs identifies novel therapeutics for organ transplantation","volume":"210","author":"Khatri","year":"2013","journal-title":"J. Exp. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1097\/MOT.0000000000000328","article-title":"Self-antigens and rejection: A proteomic analysis","volume":"21","author":"Yang","year":"2016","journal-title":"Curr. Opin. Organ Transplant."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1056\/NEJMoa035588","article-title":"Molecular heterogeneity in acute renal allograft rejection identified by DNA microarray profiling","volume":"349","author":"Sarwal","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_15","first-page":"106","article-title":"Non-invasive approaches in the diagnosis of acute rejection in kidney transplant recipients, part II: Omics analyses of urine and blood samples","volume":"10","author":"Erpicum","year":"2017","journal-title":"Clin. Kidney J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1159\/000125935","article-title":"Metabolomics: A complementary tool in renal transplantation","volume":"160","author":"Wishart","year":"2008","journal-title":"Contrib. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1021\/pr900761m","article-title":"Association of immunosuppressant-induced protein changes in the rat kidney with changes in urine metabolite patterns: A proteo-metabonomic study","volume":"9","author":"Klawitter","year":"2010","journal-title":"J. Proteome Res."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Bouatra, S., Aziat, F., Mandal, R., Guo, A.C., Wilson, M.R., Knox, C., Bjorndahl, T.C., Krishamurthy, R., Saleem, F., and Liu, P. (2013). The human urine metabolome. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0073076"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/tri.12003","article-title":"Proteomics and metabolomics in renal transplantation-quo vadis?","volume":"26","author":"Bohra","year":"2013","journal-title":"Transpl. Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.aca.2015.02.012","article-title":"A tutorial review: Metabolomics and partial least squares-discriminant analysis-a marriage of convenience or a shotgun wedding","volume":"879","author":"Gromski","year":"2015","journal-title":"Anal. Chim. Acta"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1111\/j.1600-6143.2004.00585.x","article-title":"Banff 2003 meeting report: New diagnostic insights and standards","volume":"4","author":"Racusen","year":"2004","journal-title":"Am. J. Transplant."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1046\/j.1523-1755.1999.00299.x","article-title":"The Banff 97 working classification of renal allograft pathology","volume":"55","author":"Racusen","year":"1999","journal-title":"Kidney Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1111\/j.1600-6143.2008.02159.x","article-title":"Banff 07 classification of renal allograft pathology: Updates and future directions","volume":"8","author":"Solez","year":"2008","journal-title":"Am. J. Transplant."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1056\/NEJMra0902927","article-title":"Rejection of the kidney allograft","volume":"363","author":"Nankivell","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1007\/s00467-008-0869-z","article-title":"Chronic allograft nephropathy","volume":"24","author":"Fletcher","year":"2009","journal-title":"Pediatric Nephrol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"10038","DOI":"10.1021\/ac9019522","article-title":"FiehnLib: Mass spectral and retention index libraries for metabolomics based on quadrupole and time-of-flight gas chromatography\/mass spectrometry","volume":"81","author":"Kind","year":"2009","journal-title":"Anal. Chem."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.ab.2007.01.028","article-title":"A comprehensive urinary metabolomic approach for identifying kidney cancerr","volume":"363","author":"Kind","year":"2007","journal-title":"Anal. Biochem."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1093\/bioinformatics\/btk039","article-title":"MZmine: Toolbox for processing and visualization of mass spectrometry based molecular profile data","volume":"22","author":"Katajamaa","year":"2006","journal-title":"Bioinformatics"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1021\/ac051437y","article-title":"XCMS: Processing mass spectrometry data for metabolite profiling using nonlinear peak alignment, matching, and identification","volume":"78","author":"Smith","year":"2006","journal-title":"Anal. Chem."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1093\/bioinformatics\/btr597","article-title":"MissForest-non-parametric missing value imputation for mixed-type data","volume":"28","author":"Stekhoven","year":"2012","journal-title":"Bioinformatics"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1023\/A:1010933404324","article-title":"Random forests","volume":"45","author":"Breiman","year":"2001","journal-title":"Mach. Learn."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"19","DOI":"10.32614\/RJ-2015-018","article-title":"VSURF: An R Package for Variable Selection Using Random Forests","volume":"7","author":"Genuer","year":"2015","journal-title":"R. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"837","DOI":"10.2307\/2531595","article-title":"Comparing the Areas under 2 or More Correlated Receiver Operating Characteristic Curves-a Nonparametric Approach","volume":"44","author":"Delong","year":"1988","journal-title":"Biometrics"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"W486","DOI":"10.1093\/nar\/gky310","article-title":"MetaboAnalyst 4.0: Towards more transparent and integrative metabolomics analysis","volume":"46","author":"Chong","year":"2018","journal-title":"Nucleic Acids Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.humimm.2018.01.006","article-title":"Urine biomarkers informative of human kidney allograft rejection and tolerance","volume":"79","author":"Nissaisorakarn","year":"2018","journal-title":"Hum. Immunol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/prca.200900124","article-title":"Shotgun proteomics identifies proteins specific for acute renal transplant rejection","volume":"4","author":"Sigdel","year":"2010","journal-title":"Proteom. Clin. Appl."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1002\/prca.201000117","article-title":"Profiling the proteome in renal transplantation","volume":"5","author":"Sigdel","year":"2011","journal-title":"Proteom. Clin. Appl."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1111\/j.1399-3046.2008.01018.x","article-title":"The proteogenomic path towards biomarker discovery","volume":"12","author":"Sigdel","year":"2008","journal-title":"Pediatric Transplant."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1586\/epr.11.66","article-title":"Recent advances in biomarker discovery in solid organ transplant by proteomics","volume":"8","author":"Sigdel","year":"2011","journal-title":"Expert Rev. Proteom."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/j.kint.2015.12.049","article-title":"Mining the human urine proteome for monitoring renal transplant injury","volume":"89","author":"Sigdel","year":"2016","journal-title":"Kidney Int."},{"key":"ref_41","first-page":"57","article-title":"Perturbations in the urinary exosome in transplant rejection","volume":"1","author":"Sigdel","year":"2014","journal-title":"Front. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1097\/TP.0b013e318295ee5a","article-title":"A rapid noninvasive assay for the detection of renal transplant injury","volume":"96","author":"Sigdel","year":"2013","journal-title":"Transplantation"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1681\/ASN.2015010107","article-title":"Urine Metabolite Profiles Predictive of Human Kidney Allograft Status","volume":"27","author":"Suhre","year":"2016","journal-title":"J. Am. Soc. Nephrol. JASN"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2607","DOI":"10.1681\/ASN.2015040353","article-title":"Urine CXCL10\/IP-10 Fingers Ongoing Antibody-Mediated Kidney Graft Rejection","volume":"26","author":"Fairchild","year":"2015","journal-title":"J. Am. Soc. Nephrol. JASN"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1056\/NEJM200103293441301","article-title":"Noninvasive diagnosis of renal-allograft rejection by measurement of messenger RNA for perforin and granzyme B in urine","volume":"344","author":"Li","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.jpba.2016.12.037","article-title":"Dose-response characteristics of Clematis triterpenoid saponins and clematichinenoside AR in rheumatoid arthritis rats by liquid chromatography\/mass spectrometry-based serum and urine metabolomics","volume":"136","author":"Li","year":"2017","journal-title":"J. Pharm. Biomed. Anal."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1097\/01.tp.0000268808.39401.e8","article-title":"Detection of subclinical tubular injury after renal transplantation: Comparison of urine protein analysis with allograft histopathology","volume":"84","author":"Schaub","year":"2007","journal-title":"Transplantation"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/01.ASN.0000101031.52826.BE","article-title":"Proteomic-based detection of urine proteins associated with acute renal allograft rejection","volume":"15","author":"Schaub","year":"2004","journal-title":"J. Am. Soc. Nephrol. JASN"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1097\/00007890-200110270-00021","article-title":"The urine protein to creatinine ratio (P\/C) as a predictor of 24-hour urine protein excretion in renal transplant patients","volume":"72","author":"Torng","year":"2001","journal-title":"Transplantation"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1093\/ndt\/gfq554","article-title":"Dialysis modality-dependent changes in serum metabolites: Accumulation of inosine and hypoxanthine in patients on haemodialysis","volume":"26","author":"Choi","year":"2011","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2339","DOI":"10.1111\/ajt.12837","article-title":"Urinary metabolomics for noninvasive detection of borderline and acute T cell-mediated rejection in children after kidney transplantation","volume":"14","author":"Sharma","year":"2014","journal-title":"Am. J. Transplant."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/TP.0000000000000039","article-title":"Assessing the metabolic effects of calcineurin inhibitors in renal transplant recipients by urine metabolic profiling","volume":"98","author":"Dieme","year":"2014","journal-title":"Transplantation"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e78","DOI":"10.1097\/TXD.0000000000000589","article-title":"Detecting Renal Allograft Inflammation Using Quantitative Urine Metabolomics and CXCL10","volume":"2","author":"Ho","year":"2016","journal-title":"Transplant. Direct"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1152\/ajplegacy.1975.229.2.298","article-title":"Hepatic bile acid transport: Effect of conjugation and position of hydroxyl groups","volume":"229","author":"Hoffman","year":"1975","journal-title":"Am. J. Physiol"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1423-0127-17-S1-S4","article-title":"Taurine and the renal system","volume":"17","author":"Chesney","year":"2010","journal-title":"J. Biomed. Sci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/BF00805717","article-title":"Taurine: A therapeutic agent in experimental kidney disease","volume":"11","author":"Trachtman","year":"1996","journal-title":"Amino Acids"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1006\/bbrc.1994.1235","article-title":"Antioxidants reverse the antiproliferative effect of high glucose and advanced glycosylation end products in cultured rat mesangial cells","volume":"199","author":"Trachtman","year":"1994","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/BF00585147","article-title":"Renal tubular reabsorption of taurine, gamma-aminobutyric acid (GABA) and beta-alanine studied by continuous microperfusion","volume":"367","author":"Dantzler","year":"1976","journal-title":"Pflug. Arch."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1515\/bmc-2012-0001","article-title":"The role of hyperosmotic stress in inflammation and disease","volume":"3","author":"Brocker","year":"2012","journal-title":"Biomol. Concepts"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1046\/j.1523-1755.1999.00235.x","article-title":"Osmotic regulation of the Na+\/myo-inositol cotransporter and postinduction normalization","volume":"55","author":"Yorek","year":"1999","journal-title":"Kidney Int."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1038\/ki.2013.497","article-title":"Uremic solutes and risk of end-stage renal disease in type 2 diabetes: Metabolomic study","volume":"85","author":"Niewczas","year":"2014","journal-title":"Kidney Int."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1046\/j.1523-1755.1998.00747.x","article-title":"Inhibition of myo-inositol transport causes acute renal failure with selective medullary injury in the rat","volume":"53","author":"Kitamura","year":"1998","journal-title":"Kidney Int."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2156","DOI":"10.1093\/ndt\/gfy020","article-title":"Increased urinary osmolyte excretion indicates chronic kidney disease severity and progression rate","volume":"33","author":"Gil","year":"2018","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"7309","DOI":"10.1074\/jbc.R700042200","article-title":"Intracellular organic osmolytes: Function and regulation","volume":"283","author":"Burg","year":"2008","journal-title":"J. Biol. Chem."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1111\/bju.14978","article-title":"Non-Radiologic Assessment of Kidney Stones by KIT, a Spot Urine Assay","volume":"125","author":"Yang","year":"2020","journal-title":"Br. J. Urol. Int."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Yang, J.Y.C., Sarwal, R.D., Fervenza, F.C., Sarwal, M.M., and Lafayette, R.A. (2019). Noninvasive Urinary Monitoring of Progression in IgA Nephropathy. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20184463"},{"key":"ref_67","first-page":"1","article-title":"A urinary Common Rejection Module (uCRM) score for non-invasive kidney transplant monitoring","volume":"7","author":"Sigdel","year":"2019","journal-title":"PLoS ONE"},{"key":"ref_68","unstructured":"Sigdel, T., Yang, J., Bestard, O., Hsieh, S., Roedder, S., Damm, I., Liberto, J., Nandoe, S., and Sarwal, M. (2017). A Non-Invasive Urinary Common Rejection Module (uCRM) Gene Expression Score Quantifies and Differentiates Kidney Transplant Injury. Am. J. Transplant."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1126\/scitranslmed.aba2501","article-title":"A urine score for noninvasive accurate diagnosis and prediction of kidney transplant rejection","volume":"12","author":"Yang","year":"2020","journal-title":"Sci. Transl. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11306-020-01666-2","article-title":"The key points in the pre-analytical procedures of blood and urine samples in metabolomics studies","volume":"16","author":"Bi","year":"2020","journal-title":"Metabolomics"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/TP.0b013e31823bb647","article-title":"Early subclinical rejection as a risk factor for late chronic humoral rejection","volume":"93","author":"Moreso","year":"2012","journal-title":"Transplantation"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0169077","article-title":"Metabolomic profiling in individuals with a failing kidney allograft","volume":"12","author":"Bassi","year":"2017","journal-title":"PLoS ONE"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/8\/2341\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:50:50Z","timestamp":1760176250000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/8\/2341"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,22]]},"references-count":72,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,8]]}},"alternative-id":["jcm9082341"],"URL":"https:\/\/doi.org\/10.3390\/jcm9082341","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,22]]}}}