What question did this study set out to answer?

To evaluate whether plasma donor-derived cell-free DNA (dd-cfDNA) can serve as an accurate, noninvasive biomarker for diagnosing active allograft rejection and injury in kidney transplant recipients.

March 9, 2017Journal of the American Society of NephrologyOpen Access

Cell-Free DNA and Active Rejection in Kidney Allografts

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Authors

RBRoy D. BloomUniversity of Pennsylvania JBJonathan S. BrombergUniversity of Maryland, Baltimore EPEmilio D. PoggioCleveland Clinic

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Implication

Prospective cohort study demonstrates donor-derived cell-free DNA identifies active rejection in kidney transplant recipients, indicating its utility as a noninvasive monitoring biomarker.

Key Points

To evaluate whether plasma donor-derived cell-free DNA (dd-cfDNA) can serve as an accurate, noninvasive biomarker for diagnosing active allograft rejection and injury in kidney transplant recipients.
Conducted a prospective study collecting scheduled and indication-directed plasma samples paired with 107 allograft biopsies across 102 kidney transplant recipients.
Quantified plasma dd-cfDNA fractions and correlated them with histologic classifications of rejection, including antibody-mediated rejection (ABMR) and T cell–mediated rejection (TCMR).
Discriminated any rejection from histology-negative controls with an AUC of 0.74 (95% CI, 0.61 to 0.86; P < 0.001); a 1.0% dd-cfDNA cutoff yielded a 61% PPV and 84% NPV.
Identified ABMR with an AUC of 0.87 (95% CI, 0.75 to 0.97), providing a 44% PPV and 96% NPV at the 1.0% dd-cfDNA threshold.
Observed median dd-cfDNA levels of 2.9% in ABMR, 1.2% in TCMR types ≥IB, 0.2% in TCMR type IA, and 0.3% in controls (P = 0.05 for TCMR ≥IB versus controls).

Cite This Study

Bloom et al. (2017) studied this question.

synapsesocial.com/papers/6a7daa3a7096e04f9ca142a6 https://doi.org/10.1681/asn.2016091034

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Implication

Prospective cohort study demonstrates donor-derived cell-free DNA identifies active rejection in kidney transplant recipients, indicating its utility as a noninvasive monitoring biomarker.

Cell-Free DNA and Active Rejection in Kidney Allografts

Discussion

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Implication

Key Points

Cite This Study

Cell-Free DNA and Active Rejection in Kidney Allografts

Discussion

Member takes

Implication

Key Points

Cite This Study

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