| Title: |
Integrating Donor Derived Cell-Free DNA Fraction and Absolute Quantification for Enhanced Rejection Diagnosis in Kidney Transplant Recipients. |
| Authors: |
Nie, Weijian, Wang, Yan, Fu, Qian, Wu, Chenglin, Deng, Ronghai, Yu, Xiaolin, Ye, Caiguo, Liu, Xiangjun, Xu, Bowen, Sun, Pingping, Liu, Longshan, Li, Jun, Zhang, Huanxi, Wang, Changxi |
| Source: |
Diagnostics (2075-4418); Feb2025, Vol. 15 Issue 3, p237, 11p |
| Subject Terms: |
KIDNEY transplantation, CELL-free DNA, RECEIVER operating characteristic curves, GRAFT rejection, APRIL Fools' Day |
| Abstract: |
Background: This study aimed to assess the diagnostic accuracy of combining donor-derived cell-free DNA (dd-cfDNA) fraction and absolute quantification in detecting kidney allograft rejection. Methods: A prospective study was conducted from December 2019 to April 2021 at the First Affiliated Hospital of Sun Yat-sen University. Kidney transplant recipients who underwent biopsy, including cases of T-cell-mediated rejection (TCMR), antibody-mediated rejection (ABMR), and borderline rejection, were included. dd-cfDNA fraction and absolute concentrations were measured, and diagnostic efficacy was evaluated using receiver operating characteristic (ROC) analysis. The double-positive and double-negative methods were applied to assess performance. Results: A total of 50 kidney transplant recipients were included. The dd-cfDNA fraction cutoff of 1.08% achieved 93.33% sensitivity and 91.43% specificity (AUC = 0.95), with an NPV of 96.97% and a PPV of 82.35%. The absolute dd-cfDNA threshold of 32 cp/mL yielded 80.00% sensitivity and 71.43% specificity (AUC = 0.78), with an NPV of 89.29% and a PPV of 54.55%. The double-positive method provided superior accuracy, with a PPV of 91.67% and an NPV of 89.47%, demonstrating 73.33% sensitivity and 97.14% specificity. The double-negative method achieved 100% NPV and 100% sensitivity. Conclusions: Combining dd-cfDNA fraction and absolute quantification improves diagnostic accuracy for kidney transplant rejection, especially ABMR. The double-positive and double-negative approaches show high predictive value, offering potential clinical value for monitoring kidney transplant recipients. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
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