ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO2397

Class II Donor-Specific Anti-HLA Antibody Level Is the Major Determinant of Elevated Donor-Derived Cell-Free DNA in Renal Allograft Recipients

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Butiu, Maria, University of Washington, Seattle, Washington, United States
  • Obrisca, Bogdan, Fundeni Clinical Institute, Bucharest, Romania
  • Bakthavatsalam, Ramasamy, University of Washington, Seattle, Washington, United States
  • Smith, Kelly D., University of Washington, Seattle, Washington, United States
  • De Castro, Iris C., University of Washington, Seattle, Washington, United States
  • Blosser, Christopher D., University of Washington, Seattle, Washington, United States
  • Sibulesky, Lena, University of Washington, Seattle, Washington, United States
  • Kling, Catherine, University of Washington, Seattle, Washington, United States
  • Ismail, Gener, Fundeni Clinical Institute, Bucharest, Romania
  • Sorohan, Bogdan Marian, Fundeni Clinical Institute, Bucharest, Romania
  • Leca, Nicolae, University of Washington, Seattle, Washington, United States
Background

Dd-cfDNA is a biomarker of allograft injury used for rejection risk monitoring. We sought to analyze the relationship between dd-cfDNA and DSA.

Methods

We included all kidney transplant recipients (n=171) who underwent DSA and dd-cfDNA testing as part of their clinical care between 9/17-12/19 at our center. We aimed to identify independent predictors of high dd-cfDNA (at a cut-off of 1%).

Results

Table 1 outlines clinical characteristics. There was a strong association between absolute dd-cfDNA level and DSA MFI category (Figure 1). In multivariate logistic regression analysis, DSA MFI was an independent predictor of high dd-cfDNA (Figure 2).

Conclusion

Dd-cfDNA is strongly associated with class II DSAs and MFI level. Variability observed identifies dd-cfDNA as a potential biomarker for monitoring allograft injury status in patients with DSA.

Clinical Characteristics
 Low dd-cfDNA <1%High dd-cfDNA >1%p value
Number of subjects13932 
Creatinine (mg/dl)1.54±0.521.41±0.510.18
No DSA114 (82%)14(44%)<0.001
Class I DSA4(3%)1(3%) 
Class II DSA20(14.4%)15(46.9%) 
Class I+II DSA1(0.7%)2(6.2%) 
DSA MFI(median)290013200 

Donor-derived cell-free DNA level by presence and titer of DSAs

Binary logistic regression analysis regarding variables associated with a high dd-cfDNA level (>1%)

Funding

  • Commercial Support