Donor-derived Cell-free DNA in Infections in Kidney Transplant Recipients: Case Series

Naeem Goussous, MD; Wen Xie, MD; Noor Dawany, PhD; Joseph R. Scalea, MD; Amanda Bartosic, MBA; Abdolreza Haririan, MD; Roberto Kalil, MD; Cinthia Drachenberg, MD; Nadiesda Costa, MD; Matthew R. Weir, MD; Jonathan S. Bromberg, MD, PhD

doi:10.1097/TXD.0000000000001019

Transplantation Direct (Jul 2020)

Donor-derived Cell-free DNA in Infections in Kidney Transplant Recipients: Case Series

Naeem Goussous, MD,
Wen Xie, MD,
Noor Dawany, PhD,
Joseph R. Scalea, MD,
Amanda Bartosic, MBA,
Abdolreza Haririan, MD,
Roberto Kalil, MD,
Cinthia Drachenberg, MD,
Nadiesda Costa, MD,
Matthew R. Weir, MD,
Jonathan S. Bromberg, MD, PhD

Affiliations

Naeem Goussous, MD: 1 Department of Transplant Surgery, University of Maryland School of Medicine, Baltimore, MD.
Wen Xie, MD: 1 Department of Transplant Surgery, University of Maryland School of Medicine, Baltimore, MD.
Noor Dawany, PhD: 2 Department of Biomedical and Health Informatics, Children Hospital of Philadelphia, Philadelphia, PA.
Joseph R. Scalea, MD: 1 Department of Transplant Surgery, University of Maryland School of Medicine, Baltimore, MD.
Amanda Bartosic, MBA: 1 Department of Transplant Surgery, University of Maryland School of Medicine, Baltimore, MD.
Abdolreza Haririan, MD: 3 Department of Transplant Nephrology, University of Maryland School of Medicine, Baltimore, MD.
Roberto Kalil, MD: 3 Department of Transplant Nephrology, University of Maryland School of Medicine, Baltimore, MD.
Cinthia Drachenberg, MD: 4 Department of Pathology, University of Maryland School of Medicine, Baltimore, MD.
Nadiesda Costa, MD: 3 Department of Transplant Nephrology, University of Maryland School of Medicine, Baltimore, MD.
Matthew R. Weir, MD: 3 Department of Transplant Nephrology, University of Maryland School of Medicine, Baltimore, MD.
Jonathan S. Bromberg, MD, PhD: 1 Department of Transplant Surgery, University of Maryland School of Medicine, Baltimore, MD.

DOI: https://doi.org/10.1097/TXD.0000000000001019
Journal volume & issue: Vol. 6, no. 7
p. e568

Abstract

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Background. Donor-derived cell-free DNA (dd-cfDNA) is a noninvasive plasma biomarker to evaluate for transplant allograft rejection. The relationship between infectious complications in kidney allografts and dd-cfDNA has received cursory attention in prior publications. Methods. Retrospective review of all renal transplant recipients who underwent dd-cfDNA testing between November 2017 and August 2019. Results. We report on 7 cases in whom infections affecting the transplanted kidney were associated with elevation in dd-cfDNA without concomitant rejection or elevation in serum creatinine. Five patients had BK viremia, and 2 patients had urinary tract infection associated with elevated dd-cfDNA levels. Conclusions. These observations suggest that elevations in dd-cfDNA are not specific to kidney allograft rejection and can be associated with infections affecting the transplanted kidney. This biomarker may be valuable in evaluating infectious complications of kidney allografts.

Published in Transplantation Direct

ISSN: 2373-8731 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://journals.lww.com/transplantationdirect/Pages/default.aspx

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