| Autor: |
Justin P. Rosenheck, David J. Ross, Mena Botros, Alexander Wong, Jonathan Sternberg, Yen-An Chen, Nathan Liang, Amy Baer, Ebad Ahmed, Ryan Swenerton, Bernhard G. Zimmermann, Gordon Fehringer, Zachary P. Demko, Michael Olymbios, Paul R. Billings, Brian C. Keller |
| Rok vydání: |
2021 |
| Předmět: |
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| Zdroj: |
Transplantation direct. 8(4) |
| ISSN: |
2373-8731 |
| Popis: |
Lung transplant patients are vulnerable to various forms of allograft injury, whether from acute rejection (AR) (encompassing acute cellular rejection [ACR] and antibody-mediated rejection [AMR]), chronic lung allograft dysfunction (CLAD), or infection (INFXN). Previous research indicates that donor-derived cell-free DNA (dd-cfDNA) is a promising noninvasive biomarker for the detection of AR and allograft injury. Our aim was to validate a clinical plasma dd-cfDNA assay for detection of AR and other allograft injury and to confirm and expand on dd-cfDNA and allograft injury associations observed in previous studies.We measured dd-cfDNA fraction using a novel single-nucleotide polymorphism-based assay in prospectively collected plasma samples paired with clinical-pathologic diagnoses. dd-cfDNA fraction was compared across clinical-pathologic cohorts: stable, ACR, AMR, isolated lymphocytic bronchiolitis, CLAD/neutrophilic-responsive allograft dysfunction (NRAD), and INFXN. Performance characteristics were calculated for AR and combined allograft injury (AR + CLAD/NRAD + INFXN) versus the stable cohort.The study included 195 samples from 103 patients. Median dd-cfDNA fraction was significantly higher for ACR (1.43%, interquartile range [IQR]: 0.67%-2.32%,These results indicate that our dd-cfDNA assay detects AR and other allograft injury. dd-cfDNA monitoring, accompanied by standard clinical assessments, represents a valuable precision tool to support lung transplant health and is appropriate for further assessment in a prospective randomized-controlled study. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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