Single‐center utilization of donor‐derived cell‐free DNA testing in the management of heart transplant patients
| العنوان: | Single‐center utilization of donor‐derived cell‐free DNA testing in the management of heart transplant patients |
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| المؤلفون: | Michael E. Nassif, Andrew Kao, Brett W. Sperry, Bethany A. Austin, Keerthi T. Gondi, Anthony Magalski, S.L. Lawhorn, Mark P. Everley, Taiyeb M. Khumri, A. Michael Borkon, Timothy J. Fendler, Jodie Linard, Deepthi Vodnala |
| المصدر: | Clinical Transplantation. 35 |
| بيانات النشر: | Wiley, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Graft Rejection, Transplantation, medicine.medical_specialty, business.industry, Urology, Single Center, Lower risk, Kidney Transplantation, Tissue Donors, Endomyocardial biopsy, Cell-free fetal DNA, Heart Transplantation, Humans, Medicine, Transplant patient, Donor derived, business, Cell-Free Nucleic Acids |
| الوصف: | Background Gene expression profiling (GEP) and donor-derived cell-free DNA (dd-cfDNA) are useful in acute rejection (AR) surveillance in orthotopic heart transplant (OHT) patients. We report a single-center experience of combined GEP and dd-cfDNA testing for AR surveillance. Methods GEP and dd-cfDNA are tested together starting at 2 months post-OHT. After 6 months, combined testing was obtained before scheduled endomyocardial biopsy (EMB), and EMB was canceled with a negative dd-cfDNA. This approach was compared to using a GEP-only approach, where EMB was canceled with a negative GEP. We evaluated for frequency of EMB cancellation with dd-cfDNA usage. Results A total of 153 OHT patients over a 13-month period underwent 495 combined GEP/dd-cfDNA tests. 82.2% of dd-cfDNA tests were below threshold. Above threshold results identified high-risk patients who developed AR. 378 combined tests ≥6 months post-OHT resulted in cancellation of 83.9% EMBs as opposed to 71.2% with GEP surveillance alone. There were 2 acute cellular and 2 antibody-mediated rejection episodes, and no significant AR ≥6 months. Conclusion Routine dd-cfDNA testing alongside GEP testing yielded a significant reduction in EMB volume by re-classifying GEP (+) patients into a lower risk group, without reduction in AR detection. The addition of dd-cfDNA identified patients at higher risk for AR. |
| تدمد: | 1399-0012 0902-0063 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::524a8a63d2b90bcd680da1b72d698a8e https://doi.org/10.1111/ctr.14258 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....524a8a63d2b90bcd680da1b72d698a8e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13990012 09020063 |
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