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

Repeat Kidney Transplant Patients with Active Rejection Have Elevated Donor-Derived Cell-Free DNA

S. Mehta,1 J. Chang,2 T. Hailey,1 D. Hiller,3 M. Grskovic,3 J. Yee,3 R. Mannon.1

1University of Alabama School of Medicine, Birmingham, AL
2Columbia University Medical Center, New York, NY
3CareDx, Brisbane, CA.

Meeting: 2018 American Transplant Congress

Abstract number: A98

Keywords: Kidney transplantation, Rejection, Retransplantation

Session Information

Session Name: Poster Session A: Kidney Acute Antibody Mediated Rejection

Session Type: Poster Session

Date: Saturday, June 2, 2018

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Hall 4EF

Purpose: Donor-derived cell-free DNA (dd-cfDNA) is an established marker of active rejection in de novo kidney transplant recipients. Here we characterize dd-cfDNA in patients who have received a repeat transplant since both prior and newly transplanted kidneys may be sources of dd-cfDNA found in the recipient's bloodstream. Methods: The DART study included 41 patients with more than one renal allograft in situ. Patients from the multiple transplant group who began dd-cfDNA surveillance testing (AlloSure) within 2 months post-transplant and had no rejections (n=15) and those who met the same conditions but had single kidney transplant (n=204) were included in the surveillance groups. A cohort with clinically indicated biopsy of the most recent allograft was examined for the impact of biopsy-proven active rejection on dd-cfDNA in repeat transplant patients. dd-cfDNA was measured by targeted amplification and sequencing as described previously. The assumptions in the computation of dd-cfDNA level are not impacted by the number of allografts, but do not distinguish which kidney(s) may have contributed dd-cfDNA. Results: 71 samples from the multiple transplant surveillance group had a median dd-cfDNA of 0.30% (interquartile range (IQR) 0.11%, 0.72%). 204 patients (1164 samples) with single allograft and no rejection had a significantly lower median dd-cfDNA of 0.19% (IQR 0.1%, 0.35%, p < 0.001). The demographics of the multiple and single allograft patients were similar. In 8 retransplanted patients with a diagnosis of active rejection of the most recent allograft, the median dd-cfDNA at the time of a clinically indicated biopsy was 2.06%, significantly higher than the median 0.45% (p=0.005) of 6 retransplanted patients negative for rejection at a clinically-indicated biopsy. Patients with single allograft and active rejection had a median dd-cfDNA of 1.6%, and patients with no biopsy findings of rejection had a median of 0.3%. Conclusions: Patients with multiple kidney transplants in situ have higher combined dd-cfDNA levels than patients with a single allograft. However, the dd-cfDNA levels during periods of stability are still relatively low compared to levels found in biopsy proven rejection. dd-cfDNA testing has the potential to be used to monitor active rejection and related injury in patients with repeat kidney transplants.

CITATION INFORMATION: Mehta S., Chang J., Hailey T., Hiller D., Grskovic M., Yee J., Mannon R. Repeat Kidney Transplant Patients with Active Rejection Have Elevated Donor-Derived Cell-Free DNA Am J Transplant. 2017;17 (suppl 3).

  • 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:

Mehta S, Chang J, Hailey T, Hiller D, Grskovic M, Yee J, Mannon R. Repeat Kidney Transplant Patients with Active Rejection Have Elevated Donor-Derived Cell-Free DNA [abstract]. https://atcmeetingabstracts.com/abstract/repeat-kidney-transplant-patients-with-active-rejection-have-elevated-donor-derived-cell-free-dna/. Accessed June 3, 2025.

« Back to 2018 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