Increase in nuclear cell-free DNA is associated with major adverse events in adult and pediatric heart transplant recipients.

Autor: Zangwill SD; Division of Cardiology, Phoenix Children's Hospital, Phoenix, Arizona, USA., Deshpande SR; Division of Cardiology and Division of Cardiac Intensive Care, Children's National Hospital, Washington, District of Columbia, USA., Simpson PM; Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Liang HL; Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Zhang L; Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Dasgupta M; Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Richmond ME; Department of Pediatrics, Division of Pediatric Cardiology, College of Physicians and Surgeons, Columbia University, New York, New York, USA., Kindel SJ; Division of Pediatric Cardiology, Department of Pediatrics, Medical College of Wisconsin, Herma Heart Institute, Children's Wisconsin, Milwaukee, Wisconsin, USA., Bichell DP; Division of Pediatric Cardiac Surgery, Department of Surgery, Vanderbilt University, Nashville, Tennessee, USA., Mahle WT; Division of Cardiology, Department of Pediatrics, Emory University, Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Wigger MA; Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA., Schroder JN; Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University, Durham, North Carolina, USA., Knecht KR; Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas, USA., Pahl E; Professor Emeritus Pediatrics, Cardiology, Lurie Children's Hospital, Chicago, Illinois, USA., Gaglianello NA; Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., North PE; Department of Pathology, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA., Tomita-Mitchell A; Division of Pediatric Cardiothoracic Surgery, Department of Surgery, Medical College of Wisconsin, Herma Heart Institute, Milwaukee, Wisconsin, USA., Mitchell ME; Division of Pediatric Cardiothoracic Surgery, Department of Surgery, Medical College of Wisconsin, Herma Heart Institute, Children's Wisconsin, Milwaukee, Wisconsin, USA.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2022 Jan; Vol. 36 (1), pp. e14509. Date of Electronic Publication: 2021 Nov 24.
DOI: 10.1111/ctr.14509
Abstrakt: Background: Cell-free DNA is an emerging biomarker. While donor fraction may detect graft events in heart transplant recipients, the prognostic value of total nuclear cell-free DNA (ncfDNA) itself is largely unexplored.
Objective: Explore the relationship between ncfDNA and clinical events in heart transplant recipients.
Methods: We conducted a multi-center prospective study to investigate the value of cell-free DNA in non-invasive monitoring following heart transplantation. Over 4000 blood samples were collected from 388 heart transplant patients. Total ncfDNA and donor fraction were quantified. Generalized linear models with maximum likelihood estimation for repeated measures with subjects as clusters were used to explore the relationship of ncfDNA and major adverse events. Receiver operating characteristic curves were used to help choose cutpoints.
Results: A ncfDNA threshold (50 ng/ml) was identified that was associated with increased risk of major adverse events. NcfDNA was elevated in patients who suffered cardiac arrest, required mechanical circulatory support or died post heart transplantation as well as in patients undergoing treatment for infection.
Conclusions: Elevated ncfDNA correlates with risk for major adverse events in adult and pediatric heart transplant recipients and may indicate a need for enhanced surveillance after transplant.
(© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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