Overview:

Biological markers have been around for many years. We are all familiar with biochemical indicators for example of renal or liver failure that identify broad groups of patients with organ dysfunction. We are also aware of the value of predictive markers, e.g. cholesterol, used in population screening to identify those at risk of developing certain diseases. So what is new? We are now aligned to the concept of being able to stratify patients with a particular condition into subgroups in which the disease may spontaneously progress along different paths or respond differently to treatment. In addition, technological advance has brought fresh energy to the subject, raising the hope of increased ease and accuracy for making such predictions. This conference is a meeting ground between the need for better markers that will ultimately deliver more objective clinical judgement and sub-classification of disease, and the need to understand the opportunities offered by new technology, which is evolving at a fast rate. Transplantation provides an ideal setting for the development of potential biomarkers. The precise timing and the onset of the immunological insult creates unparalleled opportunity for disease prediction, prevention, intervention and monitoring – an asset with regard to the risk of treatment complications as well the likelihood of immunological events. Moreover, this ability for forward evaluation offers the prospect to identify new mechanisms that are causally linked to the disease. Rigorous scientific standardisation is inseparable from an exposition on biomarkers, in order to be certain about the validity, reproducibility, sensitivity and specificity for each new marker or marker-set. Commercialisation and protection is also a necessary doctrine that has its place alongside this subject. The creative power of new ideas from work outside the immediate field of transplantation will deliver an important message in the final session.