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Donor Derived Cell-Free DNA Median and Distribution in Pediatric Heart Transplant Patients

J. N. Gray1, J. Miles1, K. Oreschak1, L. Jenkins1, B. Feingold2

1CareDx, South San Francisco, CA, 2Children's Hosp of Pittsburgh, Pittsburgh, PA

Meeting: 2022 American Transplant Congress

Abstract number: 234

Keywords: Heart, Heart/lung transplantation, Pediatric

Topic: Clinical Science » Heart » 63 - Heart and VADs: All Topics

Session Information

Session Name: Heart and VADs: All Topics II

Session Type: Rapid Fire Oral Abstract

Date: Monday, June 6, 2022

Session Time: 3:30pm-5:00pm

 Presentation Time: 3:30pm-3:40pm

Location: Hynes Room 210

*Purpose: The utilization of endomyocardial biopsy (EMB) in the post-transplant surveillance of pediatric heart transplant (pHT) recipients can be challenging for a myriad of reasons; however, EMB remains the gold standard in practice. Recently, the utilization of non-invasive biomarkers, such as donor derived cell free DNA (dd-cfDNA) (AlloSure, CareDx, Brisbane) have been used to identify organ injury in pediatrics to help alleviate these challenges. Our objective was to assess the performance and understand how AlloSure compared to data published in adult HT recipients.

*Methods: 614 samples from 338 unique patients were collected from June 2018 – November 2021. All patients were less than 15 years old and were managed across 61 transplant programs around the country. These samples were analyzed to determine the dd-cfDNA median and distribution in pHT recipients.

*Results: The median age at time of transplant was 6.24 years old [IQR 0.4 – 14.96]. The median dd-cfDNA of the stable patients was 0.12% [IQR 0.12 – 0.31]. Unstable patients seem to have a much wider range of elevated results the reasons for which are multifactorial. The population density kernel distribution mirrored a strongly negatively skewed distribution as previously reported in adults HT recipients.

*Conclusions: The distribution of dd-cfDNA in this cohort of pediatric patients less than 15 years old demonstrates that the overall distribution of AlloSure in pediatrics is similar to what has been previously published in adult heart recipients, with the stable pHT recipient having very low levels of dd-cfDNA.

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To cite this abstract in AMA style:

Gray JN, Miles J, Oreschak K, Jenkins L, Feingold B. Donor Derived Cell-Free DNA Median and Distribution in Pediatric Heart Transplant Patients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/donor-derived-cell-free-dna-median-and-distribution-in-pediatric-heart-transplant-patients/. Accessed May 30, 2025.

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