Preliminary clinical experience applying donor-derived cell-free DNA to discern rejection in pediatric liver transplant recipients

Abstract Donor-derived cell-free DNA (dd-cfDNA) has been of major interest recently as a non-invasive marker of graft injury, but has not yet been extensively tested in children. From May to September in 2019, a total of 76 pediatric patients receiving a liver graft were enrolled and there were 27 p...

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Autores principales:	Dong Zhao, Tao Zhou, Yi Luo, Cheng Wu, Dongwei Xu, Chengpeng Zhong, Wenming Cong, Qiang Liu, Jianjun Zhang, Qiang Xia
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/97ae131a196d49718bfc71d274bdbc5f
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spelling	oai:doaj.org-article:97ae131a196d49718bfc71d274bdbc5f2021-12-02T15:22:56ZPreliminary clinical experience applying donor-derived cell-free DNA to discern rejection in pediatric liver transplant recipients10.1038/s41598-020-80845-62045-2322https://doaj.org/article/97ae131a196d49718bfc71d274bdbc5f2021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-80845-6https://doaj.org/toc/2045-2322Abstract Donor-derived cell-free DNA (dd-cfDNA) has been of major interest recently as a non-invasive marker of graft injury, but has not yet been extensively tested in children. From May to September in 2019, a total of 76 pediatric patients receiving a liver graft were enrolled and there were 27 patients excluded. Ultimately plasma samples and matched liver specimens from 49 patients were successfully collected whenever rejection was suspected clinically. Dd-cfDNA were analyzed and then compared to biopsy. Of these, 11 (22.4%) patients were found to have rejection by biopsy. Dd-cfDNA levels were higher among patients with rejection compared to those with no rejection. In subgroup analysis, dd-cfDNA% among patients with rejection differed from those with EBV/CMV infection and DILI patients. Similarly, observations were available concerning dd-cfDNA (cp/mL). The AUC for dd-cfDNA% and dd-cfDNA (cp/mL) were 0.878, 0.841, respectively, both of which were higher than conventional LFTs. For rejection, dd-cfDNA% ≥ 28.7% yielded a sensitivity of 72.7%, specificity 94.7% and dd-cfDNA (cp/mL) ≥ 2076 cp/mL, yielded a sensitivity of 81.8%, specificity 81.9%. Of note, the dd-cfDNA distribution was significantly different between whole liver and LLS transplantation. In the setting of pediatric LTx, dd-cfDNA appears to be a sensitive biomarker indicating the presence of rejection. International Clinical Trails Registry Platform: ChiCTR1900022406.Dong ZhaoTao ZhouYi LuoCheng WuDongwei XuChengpeng ZhongWenming CongQiang LiuJianjun ZhangQiang XiaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Dong Zhao Tao Zhou Yi Luo Cheng Wu Dongwei Xu Chengpeng Zhong Wenming Cong Qiang Liu Jianjun Zhang Qiang Xia Preliminary clinical experience applying donor-derived cell-free DNA to discern rejection in pediatric liver transplant recipients
description	Abstract Donor-derived cell-free DNA (dd-cfDNA) has been of major interest recently as a non-invasive marker of graft injury, but has not yet been extensively tested in children. From May to September in 2019, a total of 76 pediatric patients receiving a liver graft were enrolled and there were 27 patients excluded. Ultimately plasma samples and matched liver specimens from 49 patients were successfully collected whenever rejection was suspected clinically. Dd-cfDNA were analyzed and then compared to biopsy. Of these, 11 (22.4%) patients were found to have rejection by biopsy. Dd-cfDNA levels were higher among patients with rejection compared to those with no rejection. In subgroup analysis, dd-cfDNA% among patients with rejection differed from those with EBV/CMV infection and DILI patients. Similarly, observations were available concerning dd-cfDNA (cp/mL). The AUC for dd-cfDNA% and dd-cfDNA (cp/mL) were 0.878, 0.841, respectively, both of which were higher than conventional LFTs. For rejection, dd-cfDNA% ≥ 28.7% yielded a sensitivity of 72.7%, specificity 94.7% and dd-cfDNA (cp/mL) ≥ 2076 cp/mL, yielded a sensitivity of 81.8%, specificity 81.9%. Of note, the dd-cfDNA distribution was significantly different between whole liver and LLS transplantation. In the setting of pediatric LTx, dd-cfDNA appears to be a sensitive biomarker indicating the presence of rejection. International Clinical Trails Registry Platform: ChiCTR1900022406.
format	article
author	Dong Zhao Tao Zhou Yi Luo Cheng Wu Dongwei Xu Chengpeng Zhong Wenming Cong Qiang Liu Jianjun Zhang Qiang Xia
author_facet	Dong Zhao Tao Zhou Yi Luo Cheng Wu Dongwei Xu Chengpeng Zhong Wenming Cong Qiang Liu Jianjun Zhang Qiang Xia
author_sort	Dong Zhao
title	Preliminary clinical experience applying donor-derived cell-free DNA to discern rejection in pediatric liver transplant recipients
title_short	Preliminary clinical experience applying donor-derived cell-free DNA to discern rejection in pediatric liver transplant recipients
title_full	Preliminary clinical experience applying donor-derived cell-free DNA to discern rejection in pediatric liver transplant recipients
title_fullStr	Preliminary clinical experience applying donor-derived cell-free DNA to discern rejection in pediatric liver transplant recipients
title_full_unstemmed	Preliminary clinical experience applying donor-derived cell-free DNA to discern rejection in pediatric liver transplant recipients
title_sort	preliminary clinical experience applying donor-derived cell-free dna to discern rejection in pediatric liver transplant recipients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/97ae131a196d49718bfc71d274bdbc5f
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Preliminary clinical experience applying donor-derived cell-free DNA to discern rejection in pediatric liver transplant recipients

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