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肾移植中供体来源游离DNA在同种异体移植监测中的应用现状

The Current State of Donor-Derived Cell-Free DNA Use in Allograft Monitoring in Kidney Transplantation.

作者信息

Kueht Michael L, Dongur Laxmi Priya, Cusick Matthew, Stevenson Heather L, Mujtaba Muhammad

机构信息

Department of Surgery, Multiorgan Transplant and Hepatobiliary Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA.

Department of Pathology, Division of Histocompatibility and Immunogenetics, University of Michigan Medicine, Ann Arbor, MI 48109, USA.

出版信息

J Pers Med. 2022 Oct 12;12(10):1700. doi: 10.3390/jpm12101700.

Abstract

Renal transplantation is the definitive therapy for patients suffering from end-stage renal disease. Though there have been significant advances in immunosuppression in these patients, there is still up to 30% acute and subclinical rejection. Current standards employ lab markers of renal function and biopsy results for accurate diagnosis. However, donor derived cell-free DNA has been identified as a measurable lab test that may be able to adequately diagnose rejection at early stages, precluding the need for invasive procedures like biopsy. We obtained published data directly from companies that offer ddcfDNA assay tests and additionally conducted a literature review using databases like PUBMED and NIH U.S. National Library of Medicine. We comprehensively compare the most used ddcfDNA assays, delineate their respective limitations, and further explore future directions in the utility of ddcfDNA in renal transplant patients.

摘要

肾移植是终末期肾病患者的确定性治疗方法。尽管这些患者的免疫抑制取得了重大进展,但仍有高达30%的急性和亚临床排斥反应。目前的标准采用肾功能实验室指标和活检结果进行准确诊断。然而,供体来源的无细胞DNA已被确定为一种可测量的实验室检测方法,它可能能够在早期充分诊断排斥反应,从而无需进行活检等侵入性操作。我们直接从提供ddcfDNA检测的公司获取已发表的数据,并另外使用PUBMED和美国国立医学图书馆等数据库进行文献综述。我们全面比较了最常用的ddcfDNA检测方法,阐述了它们各自的局限性,并进一步探索ddcfDNA在肾移植患者中的应用的未来方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f44/9605518/7c3512d4b687/jpm-12-01700-g001.jpg

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