Allogeneic
kidney transplantation is a common
transplant procedure and an optimal form of therapy for individuals who reach end-stage renal
disease, significantly improving their
quality of life, as compared to
dialysis and supportive care. Nonetheless, its success relies on lifelong
immunosuppression (IS), which causes serious complications. Moreover, despite
immunosuppression (IS), around 8% of renal transplants will be rejected due to
T cell-mediated and / or
antibody-mediated reactions towards donor-specific allo-antigens. Importantly, scarce
kidney recipients achieve an
immunosuppressive drug-free tolerance, suggesting the existence of active tolerance mechanisms. Biomarkers to predict rejection risks and identify patients in which tolerance mechanisms could allow IS
weaning, as well as a non-invasive biomarker to diagnose a rejection event, are highly needed to improve patient's care. The inventors identify circulating CD73+ DP8α Tregs or the expansion of CD73+ DP8α Tregs after
transplantation as a non-invasive biomarker to predict rejection risks from 3 months post-
transplantation. These data advocate for the potential value of these cells to improve
kidney grafted patients' care through IS minimization and / or tolerance-inducing therapies. Strikingly, these results were observed in two independent cohorts, at 1-year post-transplantation. The present invention relates to a method of determining in a subject whether a subject has or is at a risk of developing
transplant rejection comprising the steps of: i) determining the frequency of CD73-expressing DP8α Tregs among any
T cell subset in particular among total CD3+ T cells or among total CD4+ T cells or among total CD8+ T cells in a sample obtained from the subject after transplantation, ii) comparing the frequencies determined at step i) with a predetermined reference value wherein detecting differential between the frequency of CD73- expressing DP8α Tregs among any
T cell subset in particular among total CD3+ T cells or among total CD4+ T cells or among total CD8+ T cells determined at step i) and the predetermined reference value is indicative of whether a subject has or is at a risk of developing a
transplant rejection.