Remote monitoring using donor-derived, cell-free DNA after kidney transplantation during the coronavirus disease 2019 pandemic

Potter, Steven R.; Hinojosa, Randall J.; Miles, Clifford D.; O’Brien, Dan; Ross, David J.

doi:10.23876/j.krcp.20.107

Cited by 8 publications

(5 citation statements)

References 16 publications

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“…Efforts to lower the risk of transmission along with overwhelmed health care systems created significant challenges in the care of patients. Health care systems pivoted quickly towards telehealth strategies and there was increased interest in the use of non-invasive biomarkers when kidney biopsies became a challenge 66 – 68 . Although the value of monitoring strategies for allograft health remains uncertain, there does not appear to have been a dramatic uptick in acute rejection episodes 69 .…”

Section: Kidney Transplant Recipientsmentioning

confidence: 99%

Impact of the COVID-19 pandemic on the kidney community: lessons learned and future directions

et al. 2022

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The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected patients with kidney disease, causing significant challenges in disease management, kidney research and trainee education. For patients, increased infection risk and disease severity, often complicated by acute kidney injury, have contributed to high mortality. Clinicians were faced with high clinical demands, resource shortages and novel ethical dilemmas in providing patient care. In this review, we address the impact of COVID-19 on the entire spectrum of kidney care, including acute kidney injury, chronic kidney disease, dialysis and transplantation, trainee education, disparities in health care, changes in health care policies, moral distress and the patient perspective. Based on current evidence, we provide a framework for the management and support of patients with kidney disease, infection mitigation strategies, resource allocation and support systems for the nephrology workforce.

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Section: Kidney Transplant Recipientsmentioning

confidence: 99%

Impact of the COVID-19 pandemic on the kidney community: lessons learned and future directions

et al. 2022

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“…Cross assessment of the different dd-cfDNA detection methods is critical to standardize the clinical application of these studies. With its high sensitivity and noninvasiveness, adoption of dd-cfDNA testing in heart transplantation is expected to grow [54], as has been the case in kidney transplant [55].…”

Section: Discussionmentioning

confidence: 99%

Noninvasive biomarkers in heart transplant: 2020–2021 year in review

Qian¹,

Shah²,

Agbor‐Enoh

2021

Current Opinion in Organ Transplantation

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Purpose of reviewEndomyocardial biopsy (EMB), the current gold standard for cardiac allograft monitoring is invasive, may have a low sensitivity and is associated with significant variability in histopathologic interpretation. Fortunately, on-going research is identifying noninvasive biomarkers that address some of these limitations. This review provides an update on noninvasive blood-based methods for rejection surveillance and diagnosis in heart transplantation. Recent findingsRecent studies highlight good test performance to detect acute rejection for donor-derived cell-free DNA (dd-cfDNA) and microRNAs (miR). dd-cfDNA is sensitive, nonspecific, and has a high negative predictive value for acute cellular and antibody-mediated rejection. Clinical utility trials are being planned to test its role as a rule-out test for acute rejection as compared to the EMB. miRs may have an added advantage as it may phenotype the subtypes of rejection alleviating the need for an EMB or permitting the initiation of targeted therapy while awaiting the results of the EMB.

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“…Two studies demonstrated that dd-cfDNA drawn via remote home phlebotomy could be utilized for surveillance of allografts ( 22 , 23 ). This aided in identifying patients at risk of rejection and subsequent triage for allograft biopsies.…”

Section: The Pandemic Anglementioning

confidence: 99%

Donor Derived Cell Free DNA in Kidney Transplantation: The Circa 2020–2021 Update

Kant

Brennan

2022

Transpl Int

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The routine surveillance of kidney transplant allografts has relied on imperfect non-invasive biomarkers such as creatinine and urinary indices, while the gold standard allograft biopsy is associated with risk of bleeding, organ injury and sampling errors. Donor derived cell free DNA (dd-cfDNA) is being employed as a biomarker that addresses limitations of these surveillance methods, albeit has inherent drawbacks. This review provides an update on the enhanced understanding of dd-cfDNA and its expanded use beyond the conventional indication of detecting allograft rejection.

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Remote monitoring using donor-derived, cell-free DNA after kidney transplantation during the coronavirus disease 2019 pandemic

Cited by 8 publications

References 16 publications

Impact of the COVID-19 pandemic on the kidney community: lessons learned and future directions

Impact of the COVID-19 pandemic on the kidney community: lessons learned and future directions

Noninvasive biomarkers in heart transplant: 2020–2021 year in review

Donor Derived Cell Free DNA in Kidney Transplantation: The Circa 2020–2021 Update

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