Session Name: Pancreas and Islet: All Topics
Session Date & Time: None. Available on demand.
*Purpose: Donor-derived cell-free DNA (dd-cfDNA) testing, which has been previously validated for monitoring kidney transplant (KTx) rejection, may provide an alternative to pancreas biopsy that prevents morbidity and graft loss; in turn, we sought to determine for the first time baseline dd-cfDNA levels in pancreas transplant (PTx) recipients.
*Methods: Blood samples up to 19 months post-PTx were collected from 28 participants.
*Results: 25 patients received SPK, 3 received PTA, from whom 72 dd-cfDNA samples were collected of which 58 were used for baseline calculations. Three patients were excluded for infection and 11 for rejection. No patients died. Median dd-cfDNA scores peaked at 0.53% within one-month post-transplantation (range 0.20%-2.90%; mean 1.00±0.9%), then decreased to 0.20% (range 0.03%-3.60%; mean 0.45±0.8%). Median dd-cfDNA was 0.20% in patients without infection (range 0.03%-3.60%; mean 0.49±0.7%), and 2.3% with infection (range 1.10%-4.40%; mean 2.60±1%). Five patients underwent pancreas biopsy for cause (elevated lipase). Of these, three showed acute T cell mediated rejection (rejection rate 12%). The median dd-cfDNA score was higher with rejection (0.73%).
*Conclusions: While median and mean levels of normal dd-cfDNA in KTx recipients are currently defined as <1.0%, baseline dd-cfDNA levels among PTx recipients show a median level of <1.0%, but a higher mean, particularly within one-month post-transplantation (1.00±0.9%). Elevation in dd-cfDNA may also correlate with pancreas rejection. Confirmation of these correlations and definition of normal cutoffs will require accruing more patients to our study.
To cite this abstract in AMA style:Yoo A, Qian I, Riedel A, Cazac C, Bartosic A, Bromberg JS, Scalea J. Baseline Levels of Dd-cf Dna After Pancreas Transplantation: Using Dd-cfdna as an Indicator for Pancreas Rejection and Biopsy Avoidance [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/baseline-levels-of-dd-cf-dna-after-pancreas-transplantation-using-dd-cfdna-as-an-indicator-for-pancreas-rejection-and-biopsy-avoidance/. Accessed January 19, 2022.
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