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Transplant Proc. 2019 Apr;51(3):729-733. doi: 10.1016/j.transproceed.2018.10.024. Epub 2018 Dec 11.

Investigator Assessment of the Utility of the TruGraf Molecular Diagnostic Test in Clinical Practice.

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Transplant Genomics Inc, Mansfield, MA; Comprehensive Transplant Center, Northwestern University, Chicago, IL. Electronic address:
California Pacific Medical Center, San Francisco, CA.
University of Alabama at Birmingham, Birmingham, AL.
Houston Methodist Hospital, Houston, TX.
Scripps Center for Organ Transplantation, La Jolla, CA.
University of Virginia, Charlottesville, VA.
University of Wisconsin, Madison, WI.
Henry Ford Hospital, Detroit, MI.
Transplant Genomics Inc, Mansfield, MA.
Comprehensive Transplant Center, Northwestern University, Chicago, IL.



TruGraf v1 is a well-validated DNA microarray-based test that analyzes blood gene expression profiles as an indicator of immune status in kidney transplant recipients with stable renal function.


In this study, investigators assessed clinical utility of the TruGraf test in patient management. In a retrospective study, simultaneous blood tests and clinical assessments were performed in 192 patients at 7 transplant centers, and in a prospective observational study they were performed in 45 subjects at 5 transplant centers.


When queried regarding whether or not the TruGraf test result impacted their decision regarding patient management, in 168 of 192 (87.5%) cases the investigator responded affirmatively. The prospective study indicated that TruGraf results supported physicians' decisions on patient management 87% (39/45) of the time, and in 93% of cases physicians indicated that they would use serial TruGraf testing in future patient management. A total of 21 of 39 (54%) reported results confirmed their decision that no intervention was needed, and 17 of 39 (44%) reported that results specifically informed them that a decision not to perform a surveillance biopsy was correct.


TruGraf is the first and only noninvasive test to be evaluated for clinical utility in determining rejection status of patients with stable renal function and shows promise of providing support for clinical decisions to avoid unnecessary surveillance biopsies with a high degree of confidence. TruGraf is an invaluable addition to the transplant physician's tool kit for managing patient health by avoiding painful and invasive biopsies, reducing health care costs, and enabling frequent assessment of patients with stable renal function to confirm immune quiescence.

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