Kidney Disease Center, The First Affiliated Hospital of Zhejiang University, Hangzhou, China.
Zhejiang University Institute of Nephrology, Hangzhou, China.
Transpl Int. 2019 Feb;32(2):184-192. doi: 10.1111/tri.13341. Epub 2018 Oct 2.
Donor-derived cell-free DNA (ddcfDNA) is reported to be a promising noninvasive biomarker for acute rejection in organ transplant. However, studies on monitoring ddcfDNA dynamics during the early periods after organ transplantation are scarce. Our study assessed the dynamic variation in ddcfDNA in early period with various types and status of kidney transplantation. Target region capture sequencing used identifies ddcfDNA level in 21 kidney transplant recipients. Median ddcfDNA level was 20.69% at the initial time post-transplant, and decreased to 5.22% on the first day and stayed at the stable level after the second day. The ddcfDNA level in DCD (deceased donors) group (44.99%) was significantly higher than that in LDRT (living donor) group (10.24%) at initial time, P < 0.01. DdcfDNA level in DGF (delayed graft function) recipients was lower (23.96%) than that in non-DGF (47.74%) at the initial time, P = 0.89 (19.34% in DGF and 4.46% in non-DGF on the first day, P = 0.17). DdcfDNA level at initial time significantly correlated with serum creatinine (r = 0.219, P = 0.032) and warm ischemia time (r = 0.204, P = 0.040). Plasma ddcfDNA level decreased rapidly follow an L-shaped curve post-transplant, and level in DGF declined slower than non-DGF. The rebound of ddcfDNA level may indicate the occurrence of acute rejection.
供体来源的无细胞 DNA（ddcfDNA）被报道为器官移植中急性排斥反应的一种很有前途的非侵入性生物标志物。然而，关于器官移植后早期监测 ddcfDNA 动态变化的研究很少。我们的研究评估了不同类型和状态的肾移植后早期 ddcfDNA 的动态变化。目标区域捕获测序用于确定 21 名肾移植受者的 ddcfDNA 水平。移植后初始时间的中位数 ddcfDNA 水平为 20.69%，第 1 天降至 5.22%，第 2 天稳定。初始时，DCD（已故供体）组的 ddcfDNA 水平（44.99%）明显高于 LDRT（活体供体）组（10.24%），P<0.01。DGF（移植肾功能延迟恢复）受者的 ddcfDNA 水平（23.96%）低于非 DGF（47.74%），P=0.89（DGF 为 19.34%，非 DGF 为 4.46%，第 1 天，P=0.17）。初始时的 ddcfDNA 水平与血清肌酐呈显著相关（r=0.219，P=0.032）和热缺血时间（r=0.204，P=0.040）。移植后，ddcfDNA 水平迅速下降呈 L 形曲线，DGF 水平下降速度比非 DGF 慢。ddcfDNA 水平的反弹可能表明急性排斥反应的发生。
