Application of plasma donor-derived cell free DNA for lung allograft rejection diagnosis in lung transplant recipients

BMC Pulmonary Medicine

Research

Yanjun Zou¹  Feng Liu¹  Haitao Liu¹  Yang Zhou²  Qiaoyan Lian³  Jianxing He³  Yalan Yang³  Xin Xu³  Ao Chen³  Jianheng Zhang³  Chunrong Ju³  Yuhang Cai³ 

[1] AlloDx (Shanghai) Biotech., Co., Ltd, 201100, Shanghai, China;School of Life Sciences, Jiangsu University, 212013, Zhenjiang, China;State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 510000, Guangzhou, China;

关键词: Lung transplantation;    Cell-free DNA;    Acute rejection;    Infection;    Chronic lung allograft dysfunction;   

DOI  :  10.1186/s12890-022-02229-y

 received in 2022-07-07, accepted in 2022-11-07,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundDonor-derived cell-free DNA (dd-cfDNA) has been applied to monitor acute rejection (AR) in kidney and heart transplantation. This study was aimed to investigate the application of dd-cfDNA levels in the diagnosis of AR and chronic lung allograft dysfunction (CLAD) among the lung transplantation recipients (LTRs).MethodsOne hundred and seventy LTRs were enrolled at the First Affiliated Hospital of Guangzhou Medical University between 1 June 2015 and 30 March 2021. Patients were divided into 4 groups: stable group, AR group, infection group and CLAD group. The level of dd-cfDNA was analyzed using target region sequencing and the performance characteristics of dd-cfDNA for diagnosis of AR and CLAD were determined, respectively.ResultsKruskal–Wallis test showed that there were some significant differences in the level of dd-cfDNA (%) among the 4 groups, with p < 0.001. Among them, the level of dd-cfDNA (%) was highest (median 2.17, IQR [1.40–3.82]) in AR group, and higher in CLAD group (median 1.07, IQR [0.98–1.31]), but lower in infection group (median 0.71, IQR [0.57–1.07]) and lowest in stable group (median 0.71, IQR [0.61–0.84]). AUC-ROC curve analysis showed that the threshold of dd-cfDNA for AR was 1.17%, with sensitivity being 89.19% and specificity being 86.47%, and the optimal threshold of 0.89% was determined of CLAD, with sensitivity being 95.00% and specificity of 76.99%.ConclusionsPlasma dd-cfDNA could be a useful tool for the assessment of lung allograft rejection, including AR and CLAD, and holds promise as a noninvasive biomarker for “allograft injury” in both acute and chronic rejection following lung transplantation.

【 授权许可】

CC BY   
© The Author(s) 2023

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