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Abstract: PO2397

Class II Donor-Specific Anti-HLA Antibody Level Is the Major Determinant of Elevated Donor-Derived Cell-Free DNA in Renal Allograft Recipients

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Butiu, Maria, University of Washington, Seattle, Washington, United States
  • Obrisca, Bogdan, Fundeni Clinical Institute, Bucharest, Romania
  • Bakthavatsalam, Ramasamy, University of Washington, Seattle, Washington, United States
  • Smith, Kelly D., University of Washington, Seattle, Washington, United States
  • De Castro, Iris C., University of Washington, Seattle, Washington, United States
  • Blosser, Christopher D., University of Washington, Seattle, Washington, United States
  • Sibulesky, Lena, University of Washington, Seattle, Washington, United States
  • Kling, Catherine, University of Washington, Seattle, Washington, United States
  • Ismail, Gener, Fundeni Clinical Institute, Bucharest, Romania
  • Sorohan, Bogdan Marian, Fundeni Clinical Institute, Bucharest, Romania
  • Leca, Nicolae, University of Washington, Seattle, Washington, United States
Background

Dd-cfDNA is a biomarker of allograft injury used for rejection risk monitoring. We sought to analyze the relationship between dd-cfDNA and DSA.

Methods

We included all kidney transplant recipients (n=171) who underwent DSA and dd-cfDNA testing as part of their clinical care between 9/17-12/19 at our center. We aimed to identify independent predictors of high dd-cfDNA (at a cut-off of 1%).

Results

Table 1 outlines clinical characteristics. There was a strong association between absolute dd-cfDNA level and DSA MFI category (Figure 1). In multivariate logistic regression analysis, DSA MFI was an independent predictor of high dd-cfDNA (Figure 2).

Conclusion

Dd-cfDNA is strongly associated with class II DSAs and MFI level. Variability observed identifies dd-cfDNA as a potential biomarker for monitoring allograft injury status in patients with DSA.

Clinical Characteristics
 Low dd-cfDNA <1%High dd-cfDNA >1%p value
Number of subjects13932 
Creatinine (mg/dl)1.54±0.521.41±0.510.18
No DSA114 (82%)14(44%)<0.001
Class I DSA4(3%)1(3%) 
Class II DSA20(14.4%)15(46.9%) 
Class I+II DSA1(0.7%)2(6.2%) 
DSA MFI(median)290013200 

Donor-derived cell-free DNA level by presence and titer of DSAs

Binary logistic regression analysis regarding variables associated with a high dd-cfDNA level (>1%)

Funding

  • Commercial Support – CareDx Inc