دورية أكاديمية
أعرض في EDS

Relative Change in Donor-Derived Cell-free DNA is Superior to Absolute Values for Diagnosis of Acute Lung Allograft Dysfunction

التفاصيل البيبلوغرافية
العنوان: Relative Change in Donor-Derived Cell-free DNA is Superior to Absolute Values for Diagnosis of Acute Lung Allograft Dysfunction
المؤلفون: Anil J. Trindade, MD, Kaitlyn C. Chapin, AGNP-C, CCTC, Jennifer N. Gray, PharmD, Yuka Furuya, MD, MSCI, Amy Mullican, RN, Haley Hoy, ACNP, PhD, Caitlin T. Demarest, MD, PhD, Ivan M. Robbins, MD, Matthew Bacchetta, MD, MBA, David B. Erasmus, MD, Ciara M. Shaver, MD, PhD
المصدر: Transplantation Direct, Vol 9, Iss 6, p e1487 (2023)
بيانات النشر: Wolters Kluwer, 2023.
سنة النشر: 2023
المجموعة: LCC:Surgery
مصطلحات موضوعية: Surgery, RD1-811
الوصف: Background. Donor-derived cell-free DNA (dd-cfDNA%) is a biomarker of early acute lung allograft dysfunction (ALAD), with a value of ≥1.0% indicating injury. Whether dd-cfDNA% is a useful biomarker in patients >2 y posttransplant is unknown. Our group previously demonstrated that median dd-cfDNA% in lung recipients ≥2 y posttransplant without ALAD was 0.45%. In that cohort, biologic variability of dd-cfDNA% was estimated by a reference change value (RCV) of 73%, suggesting that change exceeding 73% may be pathologic. In this study, we aimed to determine whether dd-cfDNA% variability or absolute thresholds are optimal for detecting ALAD. Methods. We prospectively measured plasma dd-cfDNA% every 3 to 4 mo in patients ≥2 y post–lung transplant. ALAD was defined as infection, acute cellular rejection, possible antibody-mediated rejection, or change in forced expiratory volume in 1 s >10%, and was adjudicated retrospectively. We analyzed area under the curve for RCV and absolute dd-cfDNA% and reported performance of RCV ≥73% versus absolute value >1% for discriminating ALAD. Results. Seventy-one patients had ≥2 baseline measurements of dd-cfDNA%; 30 developed ALAD. RCV of dd-cfDNA% at ALAD had a greater area under the receiver operator characteristic curve than absolute dd-cfDNA% values (0.87 versus 0.69, P = 0.018). Test characteristics of RCV >73% for ALAD diagnosis were sensitivity 87%, specificity 78%, positive predictive value 74%, and negative predictive value 89%. In contrast, dd-cfDNA% ≥1% had sensitivity 50%, specificity 78%, positive predictive value 63%, and negative predictive value 68%. Conclusions. Relative change in dd-cfDNA% has improved test characteristics for diagnosing ALAD compared with absolute values.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2373-8731
00000000
Relation: http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001487; https://doaj.org/toc/2373-8731
DOI: 10.1097/TXD.0000000000001487
URL الوصول: https://doaj.org/article/711fae669f77454abf6c75532b107e48
رقم الأكسشن: edsdoj.711fae669f77454abf6c75532b107e48
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:23738731
00000000
DOI:10.1097/TXD.0000000000001487