Utilization of donor‐derived Cell‐Free DNA in pediatric kidney transplant recipients: A single center study

High donor‐derived cell‐free DNA (dd‐cfDNA) levels indicate transplant allograft injury and can identify graft rejection in kidney transplant recipients. Here, we evaluated the use of dd‐cfDNA in pediatric kidney transplant rejection monitoring and treatment. Methods Forty‐two pediatric kidney trans...

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Bibliographic Details
Published in:Pediatric transplantation 2024-02, Vol.28 (1), p.e14582-n/a
Main Authors: Ranch, Daniel, Fei, Mingwei, Kincade, Elisabeth, Piburn, Kim, Hitchman, Kelley, Klein, Kelsey
Format: Article
Language:English
Subjects:
acute rejection
Allografts
antibody mediated rejection
anti‐HLA antibody
Basiliximab
Biopsy
Cell-Free Nucleic Acids
Child
Graft rejection
Graft Rejection - etiology
Humans
Kidney Transplantation
Kidney transplants
Patients
pediatric kidney transplantation
Pediatrics
Surveillance
Tissue Donors
Transplant Recipients
Transplantation, Homologous
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Summary:High donor‐derived cell‐free DNA (dd‐cfDNA) levels indicate transplant allograft injury and can identify graft rejection in kidney transplant recipients. Here, we evaluated the use of dd‐cfDNA in pediatric kidney transplant rejection monitoring and treatment. Methods Forty‐two pediatric kidney transplant patients were enrolled between February 2020 and August 2021. Dd‐cfDNA was tested before and after biopsy/rejection treatment. There was a total of 61 allograft biopsies (44 for‐cause, 17 surveillance). Results Graft rejection was found in 35/61 biopsies. Rejection was more common in basiliximab induction compared to rATG (77.1% vs. 22.9%, p = .0121). Median dd‐cfDNA was higher in those with rejection (1.2% [0.34–3.12] vs. 0.24% [0.08–0.78], p 
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.14582