Factors Influencing Background Cell-Free DNA Levels: Implications for Donor-Derived Cell-Free DNA Assessment in Transplant Patients

P. Gauthier, A. Aleshin, S. Shchegrova, T. Mckenna, E. Kalashnikova, S. Sharma, H. Sethi, R. Salari, R. Swenerton, Z. Demko, B. Zimmermann, P. Billings

Natera, Inc., San Carlos, CA

Meeting: 2020 American Transplant Congress

Abstract number: LB-050

Keywords: Age factors, Graft failure, Post-operative complications, Rejection

Session Information

Session Name: Poster Session D: Late Breaking

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Detecting elevated levels of donor-derived cell-free DNA (dd-cfDNA) in the plasma of transplant recipients has been used as a metric to determine graft injury due to immunologic rejection. To clinically interpret the quantification of dd-cfDNA with respect to background cfDNA, we sought to investigate how various clinical and treatment-related factors may influence cfDNA levels.

*Methods: The impact of surgery/procedural trauma on the background cfDNA level was studied in over 1000 patient samples with early-stage cancer as well as healthy controls. Cell-free DNA levels were quantified pre-surgery and post-surgery at various time points up to six weeks. For a subset of patients, regression analysis was performed to establish the relationship between total cfDNA levels with age and gender.

*Results: Compared to the presurgical time point, plasma samples collected within the first four weeks post-surgery showed a significant increase in total cfDNA level (p<0.01). Background cfDNA level was found to be associated with increasing age but not gender. Further analysis of the impact of concurrent medications, treatment-related adverse events, and comorbidities on cfDNA levels are currently underway and will be presented.

*Conclusions: Cell-free DNA levels are unstable and can be influenced by multiple factors including age, gender, body mass index, diet, autoimmune diseases, tumor type, stage, volume and specifically surgery/procedural trauma. Considering these factors may improve the clinician’s interpretation of dd-cfDNA results.

To cite this abstract in AMA style:

Gauthier P, Aleshin A, Shchegrova S, Mckenna T, Kalashnikova E, Sharma S, Sethi H, Salari R, Swenerton R, Demko Z, Zimmermann B, Billings P. Factors Influencing Background Cell-Free DNA Levels: Implications for Donor-Derived Cell-Free DNA Assessment in Transplant Patients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/factors-influencing-background-cell-free-dna-levels-implications-for-donor-derived-cell-free-dna-assessment-in-transplant-patients/. Accessed May 31, 2025.

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