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Abstract: FR-PO885

Donor-Derived Cell-Free DNA in Renal Transplant Recipients with Delayed Graft Function

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical

Authors

  • Maw, Thin Thin, Keck School of Medicine USC, Los Angeles, California, United States
  • Bromberg, Jonathan, University of Maryland, Baltimore, Maryland, United States
  • Yee, Jim, CareDx, Pasadena, California, United States
  • Gillespie, Matthew, CareDx, Pasadena, California, United States
  • Brennan, Daniel C., Johns Hopkins, Baltimore, Maryland, United States
Background

Delayed graft function (DGF) is a major barrier to improved outcomes after kidney transplantation (KTx) with no definitive tool available to assess severity or chances for recovery. Donor-derived cell-free DNA (dd-cfDNA) was previously validated to discriminate active rejection in KTx pts but its characteristics have not been defined in those with/at risk for DGF. This report describes dd-cfDNA levels in a cohort of KTx pts with suspected DGF.

Methods

dd-cfDNA samples of KTX pts with suspected DGF at three centers were obtained between Days 1-16 post-tx as part of the Donor-derived Cell-free DNA in Blood for Diagnosing Acute Rejection in Kidney Transplant Recipients (DART) study. Similar clinical data were collected at each sample visit during this early post-tx period as was collected during later visits per DART protocol.

Results

dd-cfDNA samples were obtained from 17 KTx pts with suspected DGF. All received a deceased donor KTx (mean CIT 23 ±9 hours; mean KDPI 64 ±17). Mean dd-cfDNA level was 1.47% (SD 2.25%) in samples collected Days 1-16 post-tx and 0.60% (SD 0.99%) in samples collected at Months 1-24 post-tx. By comparison, the mean level in a reference cohort without DGF from DART was 0.34% (SD 0.58%) in samples collected 30 or more days post-tx. No obvious correlation was seen between Scr and dd-cfDNA in samples from Days 1-16 (Fig. 1) or in Months 1-24 (Fig. 2).

Conclusion

dd-cfDNA levels are higher early post-tx in suspected DGF samples vs. later time points and in those without DGF. Larger studies with long-term follow-up are needed comparing dd-cfDNA levels directly in pts with vs. without DGF after KTx. This may allow for more accurate assessment of dd-cfDNA patterns related to DGF severity/recovery.

Funding

  • Commercial Support