Sara Barrington is CEO of Verici Dx, a precision diagnostics company redefining how transplant clinicians understand and predict graft health. By combining multi-omic analysis with proprietary artificial intelligence (AI) models, Verici Dx delivers predictive, actionable intelligence that helps clinicians optimize therapy, inform biopsy decisions, and stratify risk for complex transplant patients.
In this edition of Asked & Answered, Barrington speaks with Inside Precision Medicine Editor in Chief Damian Doherty about pioneering innovation in transplant diagnostics to better reflect biological and patient complexity, and ultimately, improve health outcomes.
Q: Tell me about Verici Dx, its founding, mission, and products.
Sara Barrington: Verici Dx was founded with a very clear purpose: to fundamentally improve how transplant clinicians are informed and manage graft health. Transplant medicine requires high-stakes, time-sensitive decision-making to promote longevity of the graft, minimize the risk of complications, and improve the patient’s quality of life.
Kidney transplantation has long struggled with one fundamental challenge: accurately identifying rejection early and distinguishing it from other causes of injury and graft dysfunction. Clinicians often rely on conventional blood markers such as serum creatinine or, more recently, donor-derived cell-free DNA. While these tools are useful for signaling that “something is wrong,” they are injury markers and lack a level of precision important in rejection biology.
Creatinine levels, for example, increase only after functional damage has already occurred and cannot differentiate rejection from non-immune causes of injury such as ischemic reperfusion injury, drug toxicity, or viral infections like BK virus–associated nephropathy. Biomarkers can generate false positives, triggering biopsies or treatment escalation that may not be necessary and can expose patients to avoidable risk.
This lack of specificity has made rejection difficult to manage proactively. By the time rejection is clearly identified, tissue injury may already be established. At the same time, clinicians are understandably cautious about intensifying immunosuppression without clear evidence, given the associated risks of infection, malignancy, and toxicity.
Our mission is to close this information gap by delivering precision diagnostics that reflect the true complexity of transplant biology and translate that complexity into insights clinicians can proactively and confidently apply to patient care.
We operate at the intersection of multi-omic science, advanced analytics, and clinical reality. We know that transplant rejection and graft injury are not single-signal events, but are multifactorial, dynamic biological processes. We design our diagnostics to capture that complex biology in a way that mirrors how clinicians think about their patients, rather than forcing clinical decision-making to fit the limitations of older technologies.
Our lead product, Tutivia
, is a blood-based test that assesses the immune and broader, relevant biological status of kidney transplant patients to identify the risk of all forms of acute rejection, including T cell (TCMR) and antibody-mediated rejection (ABMR). Tutivia combines transcriptomics with proprietary AI models to address this precise unmet need: biologically accurate insight into what is actually happening within the graft.
The test delivers a risk score that enables more precise immunosuppression management by distinguishing rejection from other causes of graft injury, such as BK virus–associated nephropathy and ischemia-reperfusion injury, which can confound conventional blood tests like serum creatinine and donor-derived cell-free DNA.
By focusing on the immune and other pathways associated with rejection, Tutivia moves beyond damage markers and toward a direct assessment of rejection biology itself. That shift, from injury detection to biological interpretation, is what makes the test such a valuable tool for transplant clinicians.
Thermo Fisher Scientific recently launched its One Lambda Pre-Transplant Risk Assessment (PTRA) assay, using pre-transplant prognostic technology licensed from Verici Dx. The assay provides a risk score for early acute rejection based on a patient’s unique gene profile, helping clinicians better balance the risk of rejection against the potential side effects of over-immunosuppression. Using a 29-gene mRNA signature, the PTRA assay stratifies patients into high- and low-risk categories, with clinical validation showing high-risk patients are seven times more likely to experience early acute rejection.
Q: Tutivia is built on RNA sequencing. Why is precision transcriptomic analysis well-suited for identifying rejection biology?
Barrington: The need for reliable biomarkers is crucial for individualizing therapy that offers the potential to extend allograft survival.
Early research underpinning the science leading to the development of Tutivia was led by principal investigators at The Mount Sinai Hospital in New York, one of the world’s leading transplant research centers, combining decades of clinical expertise with rigorous science. The underlying science reflects the fact that rejection in kidney transplant patients is not driven by a single molecule or pathway, it results from coordinated immune and other biologic pathways across multiple cell types, signaling cascades, and regulatory mechanisms. Injury-driven biomarkers capture only a narrow slice of this biology and can be influenced by non-rejection factors, limiting their specificity and reliability.
Precision transcriptomic analysis, on the other hand, measures gene expression patterns across thousands of genes simultaneously. In developing specific tests, this analysis is the basis for gene selection using unsupervised deep learning mathematical modeling, allowing the most impactful and reproducible gene expression signals and interactions to be included in the final signature.
Tutivia uses a peripheral blood next-generation sequencing assay to evaluate a 17-gene mRNA signature in combination with a proprietary artificial intelligence algorithm to categorize kidney transplant patients as at low risk or high risk of acute rejection.
This provides a comprehensive view of immune activation, regulation, and injury responses within the transplanted organ, allowing the identification of signature changes that are truly characteristic of rejection biology.
In short, RNA sequencing lets us ask better biological questions: not just whether the kidney is injured, but whether immune-mediated rejection is driving that injury. That distinction is critical for precision medicine in transplantation.
Q: What does earlier and more precise identification of rejection biology mean for patient management and outcomes?
Barrington: Earlier identification of rejection biology can create an opportunity to intervene before irreversible damage occurs. When clinicians have confidence in what the biology is telling them, they can make timely, targeted decisions that may preserve graft function.
This precision also supports more individualized care. Rather than applying broad treatment strategies, clinicians can tailor immunosuppression based on biological risk, potentially reducing over-treatment and its associated complications.
For patients, this can translate into fewer unnecessary biopsies, fewer adverse events related to immunosuppression, and a greater likelihood of long-term graft survival. Ultimately, better information leads to better decisions, and better decisions lead to better outcomes.
Our vision is that precision diagnostics like Tutivia become a standard component of transplant management, providing earlier insight into rejection biology, supporting more informed clinical decisions, and helping clinicians intervene at the right time for the right patient.
Q: AI is central to your platform. How does Verici Dx apply AI differently from others in diagnostics?
Barrington: We apply AI with rigor and restraint. We use advanced machine learning and mathematical modeling to analyze highly complex biological data, but always within a disciplined scientific framework. Our models are developed using unsupervised approaches and validated extensively on inclusive patient populations. Once validated, they are locked and reproducible; they are not evolving over time. That distinction matters because clinicians are making life-altering decisions based on these results, and trust, consistency, and validation are essential.
Q: Validation and standards are recurring themes for Verici Dx. How was Tutivia validated?
Barrington: Tutivia was validated through a rigorous clinical study that included a broad and diverse transplant patient population, rather than narrowly curated cohorts. We deliberately chose a more difficult validation path because clinical reality is complex, and diagnostics must perform under those conditions. While this approach requires more time and effort, it ensures the test is reliable, reproducible, and clinically relevant across the full spectrum of patients that clinicians see every day.
Q: What’s in the future for the company?
Barrington: Verici Dx is focused on deepening the clinical adoption of Tutivia as well as expanding the studies demonstrating the utility of an earlier and more precise biomarker in improving patient outcomes. Long-term outcomes for transplant patients involve more biological pathways, and significant complexity is involved in managing care. We are focused on developing and validating tests using both transcriptomic and proteomic precision tools to assist clinicians and their patients in this journey.
Damian Doherty has been in media and publishing for over 30 years, beginning at News Corporation. Damian has managed, edited, and launched life science titles in drug discovery and precision medicine. He was features editor of Drug Discovery World and founded the Precision Medicine Leaders Summit and the Journal of Precision Medicine. He edited AIMed magazine before launching Photo51Media, a platform for illuminating untold, compelling stories in precision healthcare. Damian joined Mary Ann Liebert in 2021 to help steer the new rebrand and relaunch of Clinical OMICS to Inside Precision Medicine.
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