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논문분류	춘계학술대회 초록집
제목	Longitudinal Kinetics Of Donor-derived Cell-free DNA In Pediatric Kidney Transplantation: Absolute Copy Number Per Ml Vs. Percentage
저자	Vikas Dharnidharka
출판정보	2024; 2024(1):
키워드
초록	Objectives: Donor-derived cell-free DNA (dd-cfDNA) consists of DNA fragments released from injured donor allograft cells into circulation. In adults, post-transplant, levels decrease to about 0.92% (± 0.43%) within 30 days or 0.46% (± 0.21%) within 10 days. Previous research noted a prolonged stabilization period for dd-cfDNA in pediatric transplants, lasting at least 4 months due to donor-recipient size differences. As absolute counts of dd-cfDNA, measured as genomic copies per milliliter of plasma (cp/ml), remain unaffected by background cell-free DNA. We hypothesized that there will be no statistically significant differences observed in absolute counts, suggesting a consistent and stable trend Methods: From a biobank of 71 children, plasma samples were collected monthly post-kidney transplant (2013 onward) we quantified dd-cfDNA using next-gen sequencing for % fraction and absolute counts. Subgroup analysis included 226 samples from 54 stable renal transplant recipients without major events, studying dd-cfDNA kinetics. We quantified dd-cfDNA in plasma by next generation sequencing using a targeted, multiplex PCR-based method for the analysis of single nucleotide polymorphisms (AlloSure, CareDx, Brisbane, CA).A subgroup of 226 samples from 54 stable renal transplant recipients with no major infectious events, rejection events or delayed graft function were identified to study the dd-cfDNA kinetics over time. Results: The overall cohort had a median plasma % dd-cfDNA of 0.58 (25-75 percentile range 0.43-0.96) at 60 days post renal transplant, decreasing to 0.27% (0.11-0.72) by the fourth month, remaining steady thereafter. In contrast, absolute donor-derived cell-free DNA counts remained consistent, maintaining a median of 25 copies/ml (25-75 percentile range 12-36) at 2 months and 32 copies at month 4. Conclusions: Post-transplant, children exhibit prolonged % dd-cfDNA elevation due to increased graft-derived dd-cfDNA and reduced self-cfDNA from lower BMI. In contrast, absolute counts are superior in pediatric patients, lacking consistent fluctuations
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