Clinical Examples of the Additive Value of Absolute Quantification of Cell‐Free DNA After Heart Transplantation

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Main Authors: Jens Böhmer, Håkan Wåhlander, Kristjan Karason, Jan Sunnegårdh, Carina Wasslavik, Marianne Jonsson, Julia Asp, Anne Ricksten, Göran Dellgren
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Published: Wiley 2024
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author Jens Böhmer
Håkan Wåhlander
Kristjan Karason
Jan Sunnegårdh
Carina Wasslavik
Marianne Jonsson
Julia Asp
Anne Ricksten
Göran Dellgren
author_facet Jens Böhmer
Håkan Wåhlander
Kristjan Karason
Jan Sunnegårdh
Carina Wasslavik
Marianne Jonsson
Julia Asp
Anne Ricksten
Göran Dellgren
Jens Böhmer
Håkan Wåhlander
Kristjan Karason
Jan Sunnegårdh
Carina Wasslavik
Marianne Jonsson
Julia Asp
Anne Ricksten
Göran Dellgren
collection Wiley Open Access
contents Clinical Examples of the Additive Value of Absolute Quantification of Cell‐Free DNA After Heart Transplantation Jens Böhmer Håkan Wåhlander Kristjan Karason Jan Sunnegårdh Carina Wasslavik Marianne Jonsson Julia Asp Anne Ricksten Göran Dellgren Clinical Transplantation ABSTRACTObjectiveCell‐free DNA (cfDNA) is used as a biomarker after transplantation to detect graft injury, relying on the donor fraction (DF). We have established a PCR‐based approach allowing us to separately quantify absolute values of dd‐cfDNA and recipient‐derived cfDNA (rd‐cfDNA). We aimed to present typical clinical scenarios after heart transplantation (HTx) to illustrate the advantages of absolute cfDNA values over DF.MethodsWe used the cfDNA results of our cohort (509 samples of 52 patients followed during the first year after HTx) as background and determined the trajectories of cfDNA in specific clinical situations. We profiled an uncomplicated clinical course, viral and bacterial infections, acute and chronic rejection, and false‐negative and false‐positive rejections in six patients (five adults, one child).ResultsThere was a substantial discrepancy between relative (DF) and absolute cfDNA‐levels in several clinical situations. Rd‐ and dd‐cfDNA were independently elevated during episodes of rejection and infection and were better suited to depict treatment response than DF alone.ConclusionsAbsolute quantification of cfDNA may offer clinically relevant information additive to DF in various situations after HTx and could be helpful for more accurate monitoring of diagnosis and treatment of rejection. 10.1111/ctr.15477 http://creativecommons.org/licenses/by-nc-nd/4.0/
doi_str_mv 10.1111/ctr.15477
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institution Wiley Open Access
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publisher Wiley
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spellingShingle Clinical Examples of the Additive Value of Absolute Quantification of Cell‐Free DNA After Heart Transplantation
Jens Böhmer
Håkan Wåhlander
Kristjan Karason
Jan Sunnegårdh
Carina Wasslavik
Marianne Jonsson
Julia Asp
Anne Ricksten
Göran Dellgren
Clinical Transplantation
Clinical Examples of the Additive Value of Absolute Quantification of Cell‐Free DNA After Heart Transplantation Jens Böhmer Håkan Wåhlander Kristjan Karason Jan Sunnegårdh Carina Wasslavik Marianne Jonsson Julia Asp Anne Ricksten Göran Dellgren Clinical Transplantation ABSTRACTObjectiveCell‐free DNA (cfDNA) is used as a biomarker after transplantation to detect graft injury, relying on the donor fraction (DF). We have established a PCR‐based approach allowing us to separately quantify absolute values of dd‐cfDNA and recipient‐derived cfDNA (rd‐cfDNA). We aimed to present typical clinical scenarios after heart transplantation (HTx) to illustrate the advantages of absolute cfDNA values over DF.MethodsWe used the cfDNA results of our cohort (509 samples of 52 patients followed during the first year after HTx) as background and determined the trajectories of cfDNA in specific clinical situations. We profiled an uncomplicated clinical course, viral and bacterial infections, acute and chronic rejection, and false‐negative and false‐positive rejections in six patients (five adults, one child).ResultsThere was a substantial discrepancy between relative (DF) and absolute cfDNA‐levels in several clinical situations. Rd‐ and dd‐cfDNA were independently elevated during episodes of rejection and infection and were better suited to depict treatment response than DF alone.ConclusionsAbsolute quantification of cfDNA may offer clinically relevant information additive to DF in various situations after HTx and could be helpful for more accurate monitoring of diagnosis and treatment of rejection. 10.1111/ctr.15477 http://creativecommons.org/licenses/by-nc-nd/4.0/
title Clinical Examples of the Additive Value of Absolute Quantification of Cell‐Free DNA After Heart Transplantation
topic Clinical Transplantation
url https://onlinelibrary.wiley.com/doi/10.1111/ctr.15477