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Extremely High Cell-free DNA Levels Observed in Renal Allograft Patient With SARS-CoV-2 Infection

Beyond its widely recognized morbidity and mortality, coronavirus disease 2019 poses an additional health risk to renal allograft recipients. Detection and measurement of donor-derived cell-free DNA (dd-cfDNA), expressed as a fraction of the total cell-free DNA (cfDNA), has emerged as a noninvasive...

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Autores principales: Bunnapradist, Suphamai, Datta, Nakul, Schaenman, Joanna, Ioannou, Nick, Bloom, Michelle S., Malhotra, Meenakshi, Tabriziani, Hossein, Gauthier, Philippe, Ahmed, Ebad, Billings, Paul R., Lum, Erik L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8078311/
https://www.ncbi.nlm.nih.gov/pubmed/33912658
http://dx.doi.org/10.1097/TXD.0000000000001145
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author Bunnapradist, Suphamai
Datta, Nakul
Schaenman, Joanna
Ioannou, Nick
Bloom, Michelle S.
Malhotra, Meenakshi
Tabriziani, Hossein
Gauthier, Philippe
Ahmed, Ebad
Billings, Paul R.
Lum, Erik L.
author_facet Bunnapradist, Suphamai
Datta, Nakul
Schaenman, Joanna
Ioannou, Nick
Bloom, Michelle S.
Malhotra, Meenakshi
Tabriziani, Hossein
Gauthier, Philippe
Ahmed, Ebad
Billings, Paul R.
Lum, Erik L.
author_sort Bunnapradist, Suphamai
collection PubMed
description Beyond its widely recognized morbidity and mortality, coronavirus disease 2019 poses an additional health risk to renal allograft recipients. Detection and measurement of donor-derived cell-free DNA (dd-cfDNA), expressed as a fraction of the total cell-free DNA (cfDNA), has emerged as a noninvasive biomarker for allograft rejection. Here, we present a case report of a patient who was infected with severe acute respiratory syndrome coronavirus 2, 11 mo post–kidney transplant. The patient was serially monitored using an analytically and clinically validated massively multiplex PCR-based dd-cfDNA assay to assess allograft injury and risk for rejection. Over the course of infection, low dd-cfDNA fractions were observed (below the 1% cutoff) and were accompanied by unusually highly elevated levels of total cfDNA, which gradually declined as the infection resolved. The case study highlights the variability in total cfDNA levels during and after viral infection, and the need to consider both total and dd-cfDNA levels when clinically interpreting the results for allograft rejection. Furthermore, the study highlights the importance of serial testing, wherein an interplay between total cfDNA and dd-cfDNA can inform the optimization of a patient’s immunosuppressive treatment regimen in response to infection.
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spelling pubmed-80783112021-04-27 Extremely High Cell-free DNA Levels Observed in Renal Allograft Patient With SARS-CoV-2 Infection Bunnapradist, Suphamai Datta, Nakul Schaenman, Joanna Ioannou, Nick Bloom, Michelle S. Malhotra, Meenakshi Tabriziani, Hossein Gauthier, Philippe Ahmed, Ebad Billings, Paul R. Lum, Erik L. Transplant Direct Kidney Transplantation Beyond its widely recognized morbidity and mortality, coronavirus disease 2019 poses an additional health risk to renal allograft recipients. Detection and measurement of donor-derived cell-free DNA (dd-cfDNA), expressed as a fraction of the total cell-free DNA (cfDNA), has emerged as a noninvasive biomarker for allograft rejection. Here, we present a case report of a patient who was infected with severe acute respiratory syndrome coronavirus 2, 11 mo post–kidney transplant. The patient was serially monitored using an analytically and clinically validated massively multiplex PCR-based dd-cfDNA assay to assess allograft injury and risk for rejection. Over the course of infection, low dd-cfDNA fractions were observed (below the 1% cutoff) and were accompanied by unusually highly elevated levels of total cfDNA, which gradually declined as the infection resolved. The case study highlights the variability in total cfDNA levels during and after viral infection, and the need to consider both total and dd-cfDNA levels when clinically interpreting the results for allograft rejection. Furthermore, the study highlights the importance of serial testing, wherein an interplay between total cfDNA and dd-cfDNA can inform the optimization of a patient’s immunosuppressive treatment regimen in response to infection. Lippincott Williams & Wilkins 2021-04-23 /pmc/articles/PMC8078311/ /pubmed/33912658 http://dx.doi.org/10.1097/TXD.0000000000001145 Text en Copyright © 2021 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Kidney Transplantation
Bunnapradist, Suphamai
Datta, Nakul
Schaenman, Joanna
Ioannou, Nick
Bloom, Michelle S.
Malhotra, Meenakshi
Tabriziani, Hossein
Gauthier, Philippe
Ahmed, Ebad
Billings, Paul R.
Lum, Erik L.
Extremely High Cell-free DNA Levels Observed in Renal Allograft Patient With SARS-CoV-2 Infection
title Extremely High Cell-free DNA Levels Observed in Renal Allograft Patient With SARS-CoV-2 Infection
title_full Extremely High Cell-free DNA Levels Observed in Renal Allograft Patient With SARS-CoV-2 Infection
title_fullStr Extremely High Cell-free DNA Levels Observed in Renal Allograft Patient With SARS-CoV-2 Infection
title_full_unstemmed Extremely High Cell-free DNA Levels Observed in Renal Allograft Patient With SARS-CoV-2 Infection
title_short Extremely High Cell-free DNA Levels Observed in Renal Allograft Patient With SARS-CoV-2 Infection
title_sort extremely high cell-free dna levels observed in renal allograft patient with sars-cov-2 infection
topic Kidney Transplantation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8078311/
https://www.ncbi.nlm.nih.gov/pubmed/33912658
http://dx.doi.org/10.1097/TXD.0000000000001145
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