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Use of Donor-Derived Cell-Free DNA for Assessment of Allograft Injury in Kidney Transplant Recipients During the Time of the Coronavirus Disease 2019 Pandemic.
Garg, Neetika; Hidalgo, Luis G; Aziz, Fahad; Parajuli, Sandesh; Mohamed, Maha; Mandelbrot, Didier A; Djamali, Arjang.
  • Garg N; Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States. Electronic address: ngarg@medicine.wisc.edu.
  • Hidalgo LG; LA Laboratory, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States.
  • Aziz F; Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States.
  • Parajuli S; Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States.
  • Mohamed M; Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States.
  • Mandelbrot DA; Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States.
  • Djamali A; Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States; Division of Transplant Surgery, University of Wisconsin School of Medicine and Public Health Madison, Wisconsin, United States.
Transplant Proc ; 52(9): 2592-2595, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-720725
ABSTRACT

BACKGROUND:

Kidney allograft biopsy is the gold standard for diagnosis of rejection. Under the current extraordinary circumstances of the coronavirus disease 2019 (COVID-19), in which social distancing is key to limiting the spread of the virus, the model used to provide care to transplant recipients has undergone a very rapid transformation. In the spirit of medical distancing, we have been using the donor-derived cell-free DNA (dd-cfDNA) test for screening for rejection.

METHODS:

This article describes our experience with this approach between March 15th and May 20th, 2020.

RESULTS:

This test was obtained for-cause in 23 patients and for monitoring in 9 patients. Normal results aided in forgoing biopsy in 63% of the patients for whom the test was obtained in the outpatient setting. The test is neither 100% sensitive nor specific for rejection; however, when used in combination with the available clinical information, it can be used for determining whether bringing in a transplant recipient into a medical facility is necessary.

CONCLUSIONS:

In the event COVID-19 becomes a long-term challenge for our community, noninvasive biomarkers such as the dd-cfDNA may become more relevant than ever in enhancing our ability to care for our transplant patients while maximizing the distancing measures.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Kidney Transplantation / Coronavirus Infections / Disease Transmission, Infectious / Pandemics / Cell-Free Nucleic Acids / Graft Rejection Type of study: Diagnostic study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Transplant Proc Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Kidney Transplantation / Coronavirus Infections / Disease Transmission, Infectious / Pandemics / Cell-Free Nucleic Acids / Graft Rejection Type of study: Diagnostic study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Transplant Proc Year: 2020 Document Type: Article