Abstract: TH-PO804
Impact of Donor-Derived Cell-Free DNA Testing on Patient and Graft Outcomes
Session Information
- Transplantation: Clinical - 2
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Shuaib, Fawad, University of Kentucky, Lexington, Kentucky, United States
- Castellanos, Ana L., University of Kentucky, Lexington, Kentucky, United States
- Paluri, Sravanthi, University of Kentucky, Lexington, Kentucky, United States
- Schumacher, Lauren, University of Kentucky, Lexington, Kentucky, United States
- Philippart, Olivia, University of Kentucky, Lexington, Kentucky, United States
- Yau, Jesica, CareDx Inc, Brisbane, California, United States
- Fattah, Hasan, University of Kentucky, Lexington, Kentucky, United States
Background
The objective of this study was to compare outcomes in cohorts of patients with and without donor-derived cell-free DNA (dd-cfDNA) testing.
Methods
This is a single center retrospective cohort study of kidney transplant recipients (KTRs) comparing a historical cohort of patients transplanted from 2015-2017 without dd-cfDNA testing and cohort of patients transplanted from 2019-2022 with dd-cfDNA testing. Outcomes included BPAR, DSAs, death censored graft loss, death, and renal function at 1 year.
Results
408 KTRs were included in the analysis. There were significantly more patients with DGF and DCD donor type in the dd-cfDNA cohort (Table 1). At 1-year post-transplant, there was no significant difference in DSAs (7.4% vs 8.3%; p=0.75) or BPAR (6.5% vs 7.8%, p=0.621) between the two groups. Statistical analysis on death-censored graft loss and patient death was not performed due to few KTRs reaching these outcomes (Table 2). Serum creatinine and eGFR at 1-year was not significantly different between the two cohorts, whereas there was significantly less proteinuria in the historical cohort (7.5% vs 13.6%, p=0.044). When stratifying the dd-cfDNA cohort by results > 0.5% vs <0.5% at 3 months and 1 year, there was significantly more BPAR seen in the > 0.5% dd-cfDNA cohort.
Conclusion
There was no difference in most outcomes between the two cohorts, except for more proteinuria in the dd-cfDNA cohort. This result is limited due to higher proportion of KTRs with DGF and DCD donor type in the dd-cfDNA cohort. Assessing effectiveness of dd-cfDNA monitoring was limited to 1 year follow up period in our study. The impact of dd-cfDNA testing frequency on patient-centered outcomes remains unknown. Further studies are needed to study the ideal testing frequency impact on such outcomes.