Utility of Donor-Derived Cell-Free DNA in Detecting ABMR in Patients With AT1R Antibodies

Kant, Sam; Kumar, Dhiren; Moinuddin, Irfan; Alhamad, Tarek; Murad, Haris; Bettinotti, María P.; Brennan, Daniel C.

doi:10.1016/j.ekir.2021.07.026

Cited by 5 publications

(2 citation statements)

References 8 publications

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“…Moreover, ddcfDNA levels were elevated in patients with AMR and positive angiotensin II type 1 receptor antibodies but without DSAs, indicating potential diagnostic utility in nonhuman leucocyte antigen AMR. 72 Overall, there is some evidence that the combination of DSA and ddcfDNA predicts the presence of AMR with sufficient confidence to reduce reliance on biopsy.…”

Section: What Does the Results Mean?mentioning

confidence: 99%

Understanding Donor-derived Cell-free DNA in Kidney Transplantation: An Overview and Case-based Guide for Clinicians

et al. 2022

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Kidney transplant recipients undergo lifelong monitoring of allograft function and evaluation for transplant complications. The current monitoring paradigm utilizes blood, urine, and tissue markers that are insensitive, nonspecific, or invasive to obtain. As a result, problems are detected late, after significant damage has accrued, and often beyond the time at which complete resolution is possible. Indeed, most kidney transplants eventually fail, usually because of chronic rejection and other undetected injury. There is a clear need for a transplant-specific biomarker that enables a proactive approach to monitoring via early detection of reversible pathology. A biomarker that supports timely and personalized treatment would assist in achieving the ultimate goal of improving allograft survival and limiting therapeutic toxicity to the recipient. Donor-derived cell-free DNA (ddcfDNA) has been proposed as one such transplant biomarker. Although the test is presently utilized most in the United States, it is conceivable that its use will become more widespread. This review covers aspects of ddcfDNA that support informed use of the test by general nephrologists, including the basic biology of ddcfDNA, methodological nuances of testing, and general recommendations for use in the kidney transplant population. Clinical contexts are used to illustrate evidence-supported interpretation of ddcfDNA results and subsequent management. Finally, knowledge gaps and areas for further study are discussed.

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Section: What Does the Results Mean?mentioning

confidence: 99%

Understanding Donor-derived Cell-free DNA in Kidney Transplantation: An Overview and Case-based Guide for Clinicians

et al. 2022

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“…However, these antibodies can be present prior to transplantation, its levels cannot predict presence of rejection and a proportion of patients with the antibodies do not eventually develop rejection ( 25 ). A multicenter study involving with patients with biopsy proven ABMR and pre-existing positive AT1R antibodies, showed that dd-cfDNA correlated well with Banff components of rejection ( 3 ). Therefore, dd-cfDNA could be utilized to for surveillance and detection of incipient rejection in this setting.…”

Section: Beyond Conventional Rejectionmentioning

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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Clinical outcomes from the Assessing Donor-derived cell-free DNA Monitoring Insights of kidney Allografts with Longitudinal surveillance (ADMIRAL) study

Gupta

Pai

et al. 2022

Kidney International

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Utility of Donor-Derived Cell-Free DNA in Detecting ABMR in Patients With AT1R Antibodies

Cited by 5 publications

References 8 publications

Understanding Donor-derived Cell-free DNA in Kidney Transplantation: An Overview and Case-based Guide for Clinicians

Understanding Donor-derived Cell-free DNA in Kidney Transplantation: An Overview and Case-based Guide for Clinicians

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

Clinical outcomes from the Assessing Donor-derived cell-free DNA Monitoring Insights of kidney Allografts with Longitudinal surveillance (ADMIRAL) study

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