Utilization of donor‐derived <scp>Cell‐Free DNA</scp> in pediatric kidney transplant recipients: A single center study

Ranch, Daniel; Fei, Mingwei; Kincade, Elisabeth; Piburn, Kim; Hitchman, Kelley; Klein, Kelsey

doi:10.1111/petr.14582

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…However, due to limited data on pediatric patients, we are unable to conduct quantitative analysis in this regard. Findings from Ranch et al’s [ 24 ] study in the pediatric group indicated that when dd-cfDNA>1%, the sensitivity for diagnosing AR is 66%, with a specificity of 96%.…”

Section: Discussionmentioning

confidence: 99%

Donor-derived cell-free DNA as a diagnostic marker for kidney-allograft rejection: A systematic review and meta-analysis

Xing,

Guo,

Wang

et al. 2024

Biomol Biomed

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Testni abstrakt - Donor-derived cell-free DNA (dd-cfDNA) is a promising biomarker for the detection of graft rejection. We evaluated the accuracy and clinical value of applying it to kidney transplant rejection. Relevant literature on dd-cfDNA diagnosis of kidney transplant rejection was searched in PubMed, Embase, Cochrane Library, and Web of Science databases from the time of construction to 2023. Data and study characteristics were extracted independently by two researchers, and disagreements were resolved by negotiation. We merged diagnostic accuracy data distinguishing major rejection (MRE) and antibody-mediated rejection (AMR) separately. Potential heterogeneity was analyzed by subgroup analysis or meta-regression. Funnel plots were used to clarify the presence or absence of publication bias. A total of 17 publications provided data on the accuracy of dd-cfDNA in diagnosing patients with MRE. The pooled sensitivity, specificity, and the area under the receiver operating characteristic curve with 95% confidence intervals (CI) were 0.60 (95% CI, 0.51-0.69), 0.85 (95% CI, 0.81-0.89), and 0.83 (95% CI, 0.79-0.86), respectively. Additionally, 12 studies focused on the diagnostic efficacy of dd-cfDNA for ABMR, showing pooled sensitivity, specificity, and the area under the receiver operating characteristic curve with 95% CI of 0.81 (95% CI, 0.72–0.88), 0.80 (95% CI, 0.73–0.86), and 0.87 (95% CI, 0.84-0.90), respectively. The type of study, age group, and sample size were responsible for the heterogeneity. In summary, Due to significant heterogeneity, the accuracy of Dd-cfDNA in diagnosing patients with MRE is not very reliable. However, Dd-cfDNA can serve as a biomarker for diagnosing ABMR.

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Section: Discussionmentioning

confidence: 99%

Donor-derived cell-free DNA as a diagnostic marker for kidney-allograft rejection: A systematic review and meta-analysis

Xing,

Guo,

Wang

et al. 2024

Biomol Biomed

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miRNAs, dd-cf-DNA, and Chemokines as Potential Noninvasive Biomarkers for the Assessment of Clinical Graft Evolution and Personalized Immunosuppression Requirement in Solid Organ Transplantation

Millán,

Julian,

Brunet

2024

Therapeutic Drug Monitoring

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The use of noninvasive biomarkers may reduce the need for biopsy and guide immunosuppression adjustments during transplantation. The scientific community in solid organ transplantation currently considers that chemokines, T- and B-cell immunophenotypes, and gene expression, among other molecular biomarkers, have great potential as diagnostic and predictive biomarkers for graft evolution; however, in clinical practice, few valid early biomarkers have emerged. This review focuses on the most relevant scientific advances in this field in the last 5 years regarding the role of 3 biomarkers: miRNAs, chemokines, and ddcf-DNA, in both adult and pediatric populations. An update was provided on the scores based on the combination of these biomarkers. The most-featured articles were identified through a literature search of the PubMed database. This review provides a comprehensive analysis of the potential clinical applications of these biomarkers in the diagnosis and prediction of graft outcomes and discusses the reasons why none have been implemented in clinical practice to date. Translating these biomarkers into routine clinical practice and combining them with pharmacogenetics and pharmacokinetic monitoring is challenging; however, it is the key to present/future individualized immunosuppressive therapies. It is essential that they be shown to be applicable and robust in real-life patient conditions and properly evaluate their added value when combined with the standard-of-care factor monitoring for graft clinical assessment. Partnership strategies among scientists, academic institutions, consortia, including expert working groups and scientific societies, and pharmaceutical and/or biotechnology companies should promote the development of prospective, randomized, multicenter intervention studies for adequate clinical validation of these biomarkers and their monitoring frequency, and their commercialization to make them available to transplant physicians.

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Utilization of donor‐derived Cell‐Free DNA in pediatric kidney transplant recipients: A single center study

Cited by 2 publications

References 26 publications

Donor-derived cell-free DNA as a diagnostic marker for kidney-allograft rejection: A systematic review and meta-analysis

Donor-derived cell-free DNA as a diagnostic marker for kidney-allograft rejection: A systematic review and meta-analysis

miRNAs, dd-cf-DNA, and Chemokines as Potential Noninvasive Biomarkers for the Assessment of Clinical Graft Evolution and Personalized Immunosuppression Requirement in Solid Organ Transplantation

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