Possibility of using donor-specific cell-free DNA as biomarker for assessment of renal graft function

• Subbotina T.N.
• Kurochkin D.V.
• Shevchenko A.I.
• Khlobystin R.Yu.
• Yakimenko O.N.
• Nagovitsyna R.Yu.
• Oskorbin I.P.
• Voronina E.N.
• Filipenko M.L.

Abstract

Background. At present, non-specific clinical and laboratory parameters are used to monitor allograft status in kidney transplantation, which have low prognostic value for detection of the ongoing active rejection. One of the newest ways of early damage detection is to measure the amount of cell-free DNA in the recipient’s plasma or urine and the ability to differentiate between the cfDNA donor and recipient.

Aim – is to evaluate to evaluate the possibility of using donor-specific cell-free DNA as a biomarker to assess renal graft function.

Material and methods. We included 9 recipients who underwent kidney transplantation from 6 donors in 2021–2022 in the Federal Siberian Research Clinical Centre under the FMBA of Russia (Krasnoyarsk city). Digital PCR was used for quantitative detection of cell-free DNA (cfDNA) and donor cell-free DNA (dd-cfDNA). Serum creatinine and C-reactive protein concentrations were determined on an automatic biochemical analyser.

Results. In the process of dynamic follow-up during the early postoperative period, all recipients have a consistent decrease in the levels of the analysed parameters (dd-cfDNA, cfDNA, creatinine and C-reactive protein). One of the recipients in the late postoperative period had severe nephrotransplant dysfunction, associated with which an increase in the level of cell-free DNA of the recipient was observed. Further following the conducted treatment and restoration of the graft function the decrease in the level of creatinine and cell-free DNA of the recipient was observed.

Conclusion. The conducted study shows that the application of cell-free DNA testing and searching for donor fractions in the recipient’s blood is feasible and comparable to the results of biochemical markers.

Keywords:transplantation of the kind; cf-DNA, dd-cfDNA; acute rejection; serum сreatinin; С-reactive protein

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