Key result
Monitoring of donor-derived cell-free DNA dynamics reflected cardiac graft injury in two patients suffering acute cellular or antibody-mediated rejection, reaching maximal levels of 270 and 1,846 copies/ml during rejection episodes.
Why the study?
Endomyocardial biopsy for graft rejection surveillance is invasive with potentially serious complications, making noninvasive monitoring of graft injury and rejection via circulating donor-derived cell-free DNA an attractive option.
Does monitoring of plasma circulating donor-derived cell-free DNA (ddcfDNA) reflect cardiac graft injury in heart transplant recipients?
Case Report (n=2)
No
Does monitoring of plasma circulating donor-derived cell-free DNA (ddcfDNA) reflect cardiac graft injury in heart transplant recipients?
Monitoring of donor-derived cell-free DNA dynamics may serve as a noninvasive biomarker to reflect cardiac graft injury and acute rejection in heart transplant recipients.
ddcfDNA peaks coincided with biopsy-proven rejection; hypothesis-generating for noninvasive graft monitoring, needs prospective validation.
The current standard for graft rejection surveillance is endomyocardial biopsy (EMB), an invasive procedure with rare but potentially serious complications. Detection of circulating donor-derived cell-free DNA (ddcfDNA) is an option for noninvasive monitoring of graft injury and rejection. A 63-year-old man and a 65-year-old woman were monitored by EMB for allograft rejection. A total of 48 single-nucleotide polymorphisms with a minor allele frequency range of 0.4-0.5 were screened to distinguish donor and recipient DNA based on homozygosity, and digital droplet PCR was used to analyze ddcfDNA concentrations. Both subjects suffered rejection within the first 6 months after transplantation. The maximal ddcfDNA level of 270 copies (cp)/ml during EMB-confirmed acute cellular rejection (ACR; mild grade 1R/2, patient 1), and the maximal concentration of 1,846 cp/ml in the case of EMB-confirmed antibody-mediated rejection (AMR; grade 1+; patient 2), was detected. Individual monitoring of ddcfDNA dynamics from the 1st to the 6th month posttransplant reflected cardiac graft injury in patients suffering ACR or AMR, meaning that ddcfDNA may serve as a noninvasive biomarker.
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Dlouhá et al. (2024) conducted a case report in Heart transplantation (n=2). Donor-derived cell-free DNA (ddcfDNA) monitoring was evaluated on ddcfDNA levels during acute cellular or antibody-mediated rejection. Monitoring of donor-derived cell-free DNA dynamics reflected cardiac graft injury in two patients suffering acute cellular or antibody-mediated rejection, reaching maximal levels of 270 and 1,846 copies/ml during rejection episodes.
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