Donor-derived Cell-free DNA in Infections in Kidney Transplant Recipients: Case Series

Naeem Goussous; Wen Xie; Noor Dawany; Joseph R Scalea; Amanda Bartosic; Abdolreza Haririan; Roberto Kalil; Cinthia Drachenberg; Nadiesda Costa; Matthew R Weir; Jonathan S Bromberg

doi:10.1097/TXD.0000000000001019

Donor-derived Cell-free DNA in Infections in Kidney Transplant Recipients: Case Series

Transplant Direct. 2020 Jun 11;6(7):e568. doi: 10.1097/TXD.0000000000001019. eCollection 2020 Jul.

Affiliations

¹ Department of Transplant Surgery, University of Maryland School of Medicine, Baltimore, MD.
² Department of Biomedical and Health Informatics, Children Hospital of Philadelphia, Philadelphia, PA.
³ Department of Transplant Nephrology, University of Maryland School of Medicine, Baltimore, MD.
⁴ Department of Pathology, University of Maryland School of Medicine, Baltimore, MD.

Abstract

Background: Donor-derived cell-free DNA (dd-cfDNA) is a noninvasive plasma biomarker to evaluate for transplant allograft rejection. The relationship between infectious complications in kidney allografts and dd-cfDNA has received cursory attention in prior publications.

Methods: Retrospective review of all renal transplant recipients who underwent dd-cfDNA testing between November 2017 and August 2019.

Results: We report on 7 cases in whom infections affecting the transplanted kidney were associated with elevation in dd-cfDNA without concomitant rejection or elevation in serum creatinine. Five patients had BK viremia, and 2 patients had urinary tract infection associated with elevated dd-cfDNA levels.

Conclusions: These observations suggest that elevations in dd-cfDNA are not specific to kidney allograft rejection and can be associated with infections affecting the transplanted kidney. This biomarker may be valuable in evaluating infectious complications of kidney allografts.