Background. Protocol transbronchial biopsies (TBBx) are standard of practice (SOP) in most lung transplantation (LT) centers for surveillance of acute cellular rejection. In the context of higher LT center volumes, our program experienced increasing difficulty scheduling SOP protocol TBBx at months 1, 3, 6, 9, and 12 post-LT. As part of a Quality Assurance Performance Improvement initiative, we designed this prospective study to assess the efficacy and safety of adopting donor-derived cell-free DNA (dd-cfDNA) surveillance in lieu of protocol TBBx during the initial year after LT at our center. Methods. Enrolled LT patients with “low-risk” dd-cfDNA (75% reduction in 9M protocol TBBx procedures among patients who were “low risk” by dd-cfDNA.
Goyal et al. (Mon,) studied this question.