The evolving role of diagnostic genomics in kidney transplan
Monogenic forms of heritable kidney disease account for a significant proportion of chronic kidney disease across both paediatric and adult patient populations, and up to 11% of patients under 40 reaching end stage kidney failure and awaiting kidney transplant. Diagnostic genomics in the field of nephrology is ever evolving, and now plays an important role in assessment and management of kidney transplant recipients and their related donor pairs. Genomic testing can help identify the cause of kidney failure in kidney transplant recipients and assist in prognostication around graft survival and rate of recurrence of primary kidney disease. If a gene variant has been identified in the recipient, at risk related donors can be assessed for the same and excluded if affected. This paper aims to address the indications for genomic testing in the context for kidney transplantation, discuss the technologies available for testing, the conditions and groups in which testing should be commonly considered, and the role for the multidisciplinary renal genetics team in this process.