"Nature Reviews Nephrology" published a review: dd-cfDNA can be used to detect kidney transplant damage

Recently, the international authoritative medical journal Nature Reviews Nephrology published a review focusing on the transplant liquid biopsy biomarker—dd-cfDNA. It proposes that clinical continuous dd-cfDNA monitoring is an effective means for transplant kidney health management and can avoid premature loss of the transplant kidney.

The review notes that in kidney transplantation, finding a non-invasive biomarker more sensitive and specific than serum creatinine for early precise detection of acute and chronic rejection is crucial for long-term graft survival. Currently, donor-derived cell-free DNA (dd-cfDNA), as a candidate biomarker that can comprehensively monitor transplant kidney injury, has shown great potential. dd-cfDNA testing platforms include next-generation sequencing, digital PCR, and fluorescence quantitative PCR. Current data indicate dd-cfDNA has good diagnostic performance in detecting rejection, especially its low false-negative rate, which can avoid unnecessary clinical biopsy. Before traditional clinical diagnosis identifies transplant kidney injury, dd-cfDNA levels have already begun to rise. In addition, because cfDNA has a short half-life, dd-cfDNA levels rapidly decline to stable levels after successful rejection treatment. dd-cfDNA can detect graft injury from immune activation due to insufficient immunosuppression, so dd-cfDNA testing can help guide immunosuppressant dosing. The background abundance of dd-cfDNA may be affected by changes in recipient cfDNA (e.g., infection or exercise), but using the absolute value of dd-cfDNA solves this problem. Therefore, continuous dd-cfDNA monitoring supports cost-effective personalized clinical management of kidney transplant patients to reduce premature graft loss.