Comparison of two donor-derived cell-free DNA tests and a blood gene-expression profile test in heart transplantation.

Autor: Rodgers N; UC San Diego Health, San Diego, California, USA., Gerding B; UC San Diego Health, San Diego, California, USA., Cusi V; UC San Diego Health, San Diego, California, USA., Vaida F; Department of Family Medicine and Public Health, University of California San Diego, La Jolla, USA., Tada Y; UC San Diego Health, San Diego, California, USA., Morris GP; UC San Diego Health, San Diego, California, USA., Adler ED; UC San Diego Health, San Diego, California, USA., Stehlik J; Division of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA., Kim PJ; UC San Diego Health, San Diego, California, USA.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2023 Jun; Vol. 37 (6), pp. e14984. Date of Electronic Publication: 2023 Apr 10.
DOI: 10.1111/ctr.14984
Abstrakt: Background: Donor-derived cell-free DNA (dd-cfDNA) testing is an emerging screening modality for noninvasive detection of acute rejection (AR). This study compared the testing accuracy for AR of two commercially available dd-cfDNA and gene-expression profiling (GEP) testing in heart transplant (HTx) recipients.
Methods: This is a retrospective, observational study of HTx only patients who underwent standard and expanded single nucleotide polymorphism (SNP) dd-cfDNA between October 2020 to January 2022. Comparison with GEP was also performed. Assays were compared for correlation, accurate classification, and prediction for AR.
Results: A total of 428 samples from 112 unique HTx patients were used for the study. A positive standard SNP correlated with the expanded SNP assay (p < .001). Both standard and expanded SNP tests showed low sensitivity (39%, p = 1.0) but high specificity (82% and 84%, p = 1.0) for AR. GEP did not improve sensitivity and showed worse specificity (p < .001) compared to standard dd-cfDNA.
Conclusion: We found no significant difference between standard and expanded SNP assays in detecting AR. We show improved specificity without change in sensitivity using dd-cfDNA in place of GEP testing. Prospective controlled studies to address how to best implement dd-cfDNA testing into clinical practice are needed.
(© 2023 The Authors. Clinical Transplantation published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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