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Background: Monitoring donor-derived cell-free DNA (dd-cfDNA) is a promising noninvasive method for assessing allograft health in renal transplant recipients. This UK pilot study evaluated a novel insertion and deletion (INDEL)-based next-generation sequencing (NGS) assay for detecting dd-cfDNA and explored its association with potentially injurious concomitant pathologies, including donor-specific antibodies. Current methods are limited to first and only transplant recipients, as other assays cannot distinguish graft injury in the context of transplantation from multiple donors.

Methods: Fourteen high-risk renal transplant recipients (level IV human leukocyte antigen mismatch, calculated reaction frequency >20%, retransplant) were recruited between October 2023 and July 2024 at Liverpool University Hospitals. Plasma samples were collected 6 months posttransplant, and cfDNA was extracted using QIAsymphony DSP Circulating DNA Kit (Qiagen). dd-cfDNA was quantified using the Devyser Accept cfDNA assay (Devyser), and NGS was performed using MiSeq (Illumina).

Results: We present preliminary observations from the first 14 patients included in this proof-of-concept arm of the study. A dd-cfDNA level ≤0.5% correlated with stable graft function (n=11). Patients with dd-cfDNA ≥1.0% had supratherapeutic tacrolimus levels (n=2). Intermediate dd-cfDNA levels (0.5%–1.0%) were found in the setting of de novo donor-specific antibody emergence (n=1). We were able to identify informative markers and derive interpretable results in a multitransplant recipient setting.

Conclusions: The INDEL-based NGS assay is a promising novel tool for detecting and monitoring dd-cfDNA in renal transplant recipients with an easy-to-implement workflow.

These preliminary results support its clinical utility in a high-immunological-risk setting. These findings are consistent with emergent literature; however, longitudinal data and further validation in a larger cohort of patients are required.

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기사명 저자명 페이지 원문 목차
Exploring the utility of near-infrared spectroscopy in liver transplantation : insights and challenges Ravshan Ibadov, Konstantin Semash, Mirshavkat Akbarov, Timur Dzhanbekov, Oybek Omonov, Azimjon Usmonov, Sardor Ibragimov p. 89-96
Current status of xenotransplantation from an immunobiological standpoint Jaecheon Ko, Geon Lee, Hyun Woo Kim, Minji Kang, Hyun Je Kim, Chung-Gyu Park p. 97-115
Antibiogram pattern of recurrent urinary tract infections in kidney transplant patients : a single-center cohort study Hossein Bahari, Ali Tajik, Armin Doostparast, Reza Nejad Shahrokh Abadi, Saeed Javanshir, Mohsen Aliakbarian, Rozita Khodashahi p. 116-123
Evaluation of the correlation between six scoring systems for assessing the severity of end-stage liver disease and intraoperative blood loss during liver transplantation : a retrospective study Amer Majeed, Noon E Abdelgadir, Momina Amer, Muhammad Shabbir, Mohammed Ibrahim, Mohamad S Nagy, Bilal Tufail, Luluah Altukhaifi, Areej A G AlFattani p. 124-130
Comparing drug combinations for graftversus-host disease prophylaxis using the U.S. Food and Drug Administration Adverse Event Reporting System Toru Ogura, Chihiro Shiraishi, Aiko Urawa p. 131-141
Impact of liver disease severity on postoperative pain after living donor liver transplantation : a prospective observational study Priyanka Chuttani, Gaurav Sindwani, Viniyendra Pamecha, Nihar Mohapatra, Mahesh Kumar Arora p. 142-149
(A) novel INDEL-based next-generation sequencing assay for monitoring donor-derived cell-free DNA in renal transplant recipients—from bedside to results : a UK pilot study George E. Nita, Fotini Partheniou, Dan Ridgway, Sanjay Mehra, Matthew Howse, Abdul Hammad, Andrew R. Jones, Petra M. Goldsmith p. 150-160
Tailored strategies for emergency ABO-incompatible living donor liver transplantation : a series of three cases Nalini Kanta Ghosh, Kausar Makki, Yogesh Yadav, Tathagata Karan, Piyush Srivastava, Anil Agarwal, Vivek Vij p. 161-168
Interventional management of graft hepatic artery dissection in a donor right hepatectomy : a case report Oğuzhan Şal, Cihan Karataş, Altan Alim, Barış Demir, Levent Oğuzkurt, Turan Kanmaz p. 169-173
Living donor liver transplantation for autoimmune hepatitis in identical monozygotic twins : a case report Kulbhushan Haldeniya, Kausar Makki, Yogesh Yadav, Tathagata Karan, Nalini Kanta Ghosh, Piyush Srivastava, Anil Agarwal, Vivek Vij p. 174-178

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