ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Month 1 Donor Derived Cell Free DNA Levels Predict Future Kidney Transplant Rejection

B. M. Kinsella1, K. Guo1, C. Rebello1, L. Zhao1, S. Park2, J. Friedewald1

1Northwestern University, Chicago, IL, 2Transplant Nephrology, Northwestern University, Chicago, IL

Meeting: 2022 American Transplant Congress

Abstract number: 1587

Keywords: Genomic markers, Graft survival, Kidney transplantation, Rejection

Topic: Basic Science » Basic Clinical Science » 17 - Biomarkers: Clinical Outcomes

Session Information

Session Name: Biomarkers: Clinical Outcomes

Session Type: Poster Abstract

Date: Tuesday, June 7, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: The purpose of this study was to determine if donor-derived cell-free DNA (dd-cfDNA) can be used one-month post-transplant to predict later allograft rejection.

*Methods: Retrospective analysis of 203 subjects from a multi-center, observational study over 24 months. Dd-cfDNA levels were measured as a proportion of total cfDNA using the TRAC assay, from blood samples drawn 1-month post-transplant. Dd-cfDNA levels >0.7% are considered positive. Protocol and for cause biopsies determined rejection or no rejection status over the observation period. Subjects were grouped into 3 categories: dd-cfDNA <0.7 (group 1), dd-cfDNA level ≥0.7 and <1 (group 2), and dd-cfDNA level ≥1 (group 3). Risk of rejection and graft failure were analyzed using the logistic regression and Cox proportional hazard model.

*Results: Of 203 subjects, 136 had a 1-month dd-cfDNA <0.7 (group 1), 40 had a dd-cfDNA level => 0.7 and <1 (group 2, and 27 had a dd-cfDNA level ≥1% (fig.1). 94 (46.3%) experienced rejection at some point during the observation period and 17 (10.8%) had graft failure out to 5 years, with 17 having unknown graft status (Table 1). A higher % of dd-cfDNA in the 1st month post-transplant trended with a significantly increased risk of rejection (p=0.04). The hazard of graft failure in group 2 (HR 2.22, 95% CI [0.81-6.10], P-value = 0.12) tended to be higher than group 1 but was not statically significant. No concordance was detected between graft failure and dd-cfDNA level (p=0.2).

*Conclusions: A significant number of kidney recipients have elevated dd-cfDNA levels one-month post-transplant. Higher levels are associated with future episodes of allograft rejection. Further investigation is needed to determine if the same association exists with graft failure.

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

To cite this abstract in AMA style:

Kinsella BM, Guo K, Rebello C, Zhao L, Park S, Friedewald J. Month 1 Donor Derived Cell Free DNA Levels Predict Future Kidney Transplant Rejection [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/month-1-donor-derived-cell-free-dna-levels-predict-future-kidney-transplant-rejection/. Accessed May 30, 2025.

« Back to 2022 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences