The Unique Course of dd-cfDNA After Lung Transplant
1University of Texas Health System San Antonio, San Antonio, TX, 2CareDX, South San Francisco, CA, 3CareDx, South San Francisco, CA, 4Pneumology, Adult CF Center and Lung Transplantation Department, Foch Hospital, Suresnes, France
Meeting: 2022 American Transplant Congress
Abstract number: 1494
Keywords: Genomic markers, Lung transplantation, Non-invasive diagnosis
Topic: Clinical Science » Lung » 64 - Lung: All Topics
Session Information
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: The time necessary for dd-cfDNA to reach baseline levels following transplantation has been reported in kidney, heart, and liver as 14-21 days. We explored the time required for dd-cfDNA to reach baseline levels (<0.5%) after lung transplant.
*Methods: Eight patients were followed with serial dd-cfDNA measurements for the first 6 months post-transplant. Dd-cfDNA measurements (AlloSure, CareDx) were binned within time groups (week or month). The median across all timepoints within a given bin across all patients was calculated. A best-fit line was derived to define dd-cfDNA over time. Pulmonary function reflected by changes in FEV1 was measured from the time of discharge and compared to dd-cfDNA.
*Results: Dd-cfDNA was very high immediately following transplantation. The levels gradually decreased, with a median of 5.8% at 6 days post-transplant and 1.5% at 18 days post-transplant. The median level did not reliably stay below 0.5% until after day 70 post-transplant (Figure 1). Individual patient data demonstrate variability in this time course across patients (Figure 2).
*Conclusions: Lung transplant recipients have dd-cfDNA levels well above baseline for 60-90 days compared to 14-21 days reported after kidney and heart transplants. The initial high levels of dd-cfDNA do not appear to reflect injury that would influence the post-transplant course, based on the stability and/or improvement of FEV1 of these patients. The initial variation in decreasing dd-cfDNA levels to baseline among patients reflects the need for serial testing for an individualized patient monitoring approach.
To cite this abstract in AMA style:
Levine D, Giner C, Pham C, Woodward R, Roux A. The Unique Course of dd-cfDNA After Lung Transplant [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/the-unique-course-of-dd-cfdna-after-lung-transplant/. Accessed November 14, 2024.« Back to 2022 American Transplant Congress