Can Donor-Derived Cell-Free DNA Detect Graft-Versus-Host Disease in Solid Organ Transplantation: A Case Report

Transplant Proc. 2022 Jan-Feb;54(1):176-179. doi: 10.1016/j.transproceed.2021.11.014. Epub 2021 Dec 24.


Graft-versus-host disease (GVHD) is a rare complication after solid organ transplant. We present a case of GVHD after simultaneous pancreas kidney transplant. The patient was diagnosed with a cutaneous biopsy after developing the classic symptoms of maculopapular rash, diarrhea, and pancytopenia. However, this patient had unexplained elevations in donor-derived cell-free DNA (dd-cfDNA) for months before the onset of GVHD symptoms. We hypothesize that GVHD may be associated with elevated dd-cfDNA as a result of massive donor lymphocyte proliferation and turnover. Further investigation is warranted because earlier diagnosis and treatment could improve outcomes in an otherwise lethal disease.

Publication types

  • Case Reports

MeSH terms

  • Cell-Free Nucleic Acids*
  • Graft vs Host Disease* / diagnosis
  • Graft vs Host Disease* / etiology
  • Humans
  • Organ Transplantation*
  • Pancreas Transplantation* / adverse effects
  • Tissue Donors


  • Cell-Free Nucleic Acids