Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Background: Recently, high immunologic risk patients comprise a significant percentage of the total adult renal transplants performed yearly. Surveillance management of these patients and interpretation of donor specific antibodies (DSA) are not standardized. Maintenance and intervention protocols for these grafts are a significant cost burden to programs and efficacy remains unproven. We examined the role of donor-derived cell-free DNA (dd-cfDNA) as a measure of organ injury in rejection surveillance for these patients.
Methods: 27 high immunologic risk adult kidney transplant recipients who qualified for our DSA monitoring based protocol were prospectively enrolled at a single center between June 2015 and July 2016. dd-cfDNA and protocol DSA monitoring were evaluated longitudinally post-transplant. dd-cfDNA was quantified by an analytically validated clinical-grade next-generation sequencing assay utilizing single nucleotide polymorphisms distributed across the genome to differentiate donor and recipient cfDNA.
Results: Seven patients who developed de novo DSAs post-transplant (either C1q negative or C1q positive) exhibited significantly elevated dd-cfDNA levels. Elevated dd-cfDNA levels appeared within the month of this histologic change. The difference was statistically significant when compared to patients (n=20) without DSA changes(p=0.001). All patients without de novo DSAs post-transplant exhibited normal baseline levels of dd-cfDNA.
Conclusion: dd-cfDNA is an expedient test that predicts de novo DSAs in kidney transplant recipients. These data suggest that dd-cfDNA may serve as a novel first line screening tool for development of DSAs post-transplant and have the potential to inform post-transplant surveillance, treatment and outcomes.
CITATION INFORMATION: Brubaker A., Stoltz D., Grskovic M., Woodward R., Gallo A. Title: Donor-Derived Cell Free DNA Predicts Development of Clinically Significant Changes in Donor Specific Antibody Following Kidney Transplant Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Brubaker A, Stoltz D, Grskovic M, Woodward R, Gallo A. Title: Donor-Derived Cell Free DNA Predicts Development of Clinically Significant Changes in Donor Specific Antibody Following Kidney Transplant [abstract]. https://atcmeetingabstracts.com/abstract/title-donor-derived-cell-free-dna-predicts-development-of-clinically-significant-changes-in-donor-specific-antibody-following-kidney-transplant/. Accessed October 22, 2019.
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