Dynamics of early post-operative plasma ddcfDNA levels in kidney transplantation: a single-center pilot study
Dynamics of early post-operative plasma ddcfDNA levels in kidney transplantation: a single-center pilot study
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肾移植术后早期血浆 ddcfDNA 水平的动态：单中心试点研究
DOI：
10.1111/tri.13341
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发表时间：
2019-02-01
影响因子：
3.1
通讯作者：
Wang, Rending
中科院分区：
文献类型：
--
作者：
Shen, Jia;Zhou, Yang;Wang, Rending
据报道，供体来源的无细胞DNA （ddcfDNA）是一种很有前途的无创生物标志物，用于器官移植急性排斥反应。然而，在器官移植后早期监测ddcfDNA动态的研究很少。我们的研究评估了ddcfDNA在不同类型和状态的肾移植早期的动态变化。靶区捕获测序用于鉴定21例肾移植受者的ddcfDNA水平。移植后第1天ddcfDNA水平中位数为20.69%，第1天降至5.22%，第2天后保持稳定。DCD（死亡供者）组初始ddcfDNA水平（44.99%）显著高于LDRT（活供者）组（10.24%），DGF（延迟移植功能）组初始P DNA水平（23.96%）低于非DGF组（47.74%），P = 0.89 （DGF组第1天为19.34%，非DGF组为4.46%,P = 0.17）。初始时间DdcfDNA水平与血清肌酐（r(2) = 0.219, P = 0.032）、热缺血时间（r(2) = 0.204, P = 0.040）显著相关。移植后血浆ddcfDNA水平呈l型曲线迅速下降，DGF组下降速度慢于非DGF组。ddcfDNA水平的反弹可能提示急性排斥反应的发生。
Donor-derived cell-free DNA (ddcfDNA) is reported to be a promising noninvasive biomarker for acute rejection in organ transplant. However, studies on monitoring ddcfDNA dynamics during the early periods after organ transplantation are scarce. Our study assessed the dynamic variation in ddcfDNA in early period with various types and status of kidney transplantation. Target region capture sequencing used identifies ddcfDNA level in 21 kidney transplant recipients. Median ddcfDNA level was 20.69% at the initial time post-transplant, and decreased to 5.22% on the first day and stayed at the stable level after the second day. The ddcfDNA level in DCD (deceased donors) group (44.99%) was significantly higher than that in LDRT (living donor) group (10.24%) at initial time, P DNA level in DGF (delayed graft function) recipients was lower (23.96%) than that in non-DGF (47.74%) at the initial time, P = 0.89 (19.34% in DGF and 4.46% in non-DGF on the first day, P = 0.17). DdcfDNA level at initial time significantly correlated with serum creatinine (r(2) = 0.219, P = 0.032) and warm ischemia time (r(2) = 0.204, P = 0.040). Plasma ddcfDNA level decreased rapidly follow an L-shaped curve post-transplant, and level in DGF declined slower than non-DGF. The rebound of ddcfDNA level may indicate the occurrence of acute rejection.