{"id":1167,"date":"2023-04-21T16:57:26","date_gmt":"2023-04-21T08:57:26","guid":{"rendered":"https:\/\/www.transnovo.com\/?p=1167"},"modified":"2023-04-21T16:57:26","modified_gmt":"2023-04-21T08:57:26","slug":"gcfdna-%e9%a2%84%e6%b5%8b%e5%92%8c%e9%89%b4%e5%88%ab%e6%8e%92%e6%96%a5%e5%8f%8d%e5%ba%94%e7%9a%84%e6%96%b0%e5%9e%8b%e7%94%9f%e7%89%a9%e6%a0%87%e5%bf%97%e7%89%a9","status":"publish","type":"post","link":"https:\/\/transnovo.com\/en\/news\/gcfdna-%e9%a2%84%e6%b5%8b%e5%92%8c%e9%89%b4%e5%88%ab%e6%8e%92%e6%96%a5%e5%8f%8d%e5%ba%94%e7%9a%84%e6%96%b0%e5%9e%8b%e7%94%9f%e7%89%a9%e6%a0%87%e5%bf%97%e7%89%a9\/","title":{"rendered":"GcfDNA\u2014\u2014\u9884\u6d4b\u548c\u9274\u522b\u6392\u65a5\u53cd\u5e94\u7684\u65b0\u578b\u751f\u7269\u6807\u5fd7\u7269"},"content":{"rendered":"
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Preface<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\u00a0 China has the second highest number of organ donations and transplants in the world, and transplant rejection is a common post-operative complication.Biopsy and blood creatinine are currently the common tests used to identify postoperative rejection.<\/strong><\/p>\n

 <\/p>\n

Although biopsy is considered the \"gold standard\" for diagnosis, its high cost, invasiveness and complications, and poor reproducibility have limited its clinical use. The sensitivity and specificity of blood creatinine to identify rejection is low.1<\/sup>.<\/p>\n

 <\/p>\n

Graft\/donor-derived free DNA (GcfDNA) is free DNA from apoptotic or necrotic donor cells in the circulating body fluid of the recipient after organ transplantation.It can predict rejection at an early stage, and the sensitivity and specificity of identifying post-operative rejection are high, and unnecessary biopsy is avoided, so it is a new biomarker for predicting and identifying rejection after transplantation2<\/sup>.<\/strong><\/p>\n<\/section>\n

 <\/p>\n

 <\/p>\n

In recent years, there is more evidence-based evidence on GcfDNA in predicting and identifying postoperative rejection after kidney transplantation.<\/p>\n

 <\/p>\n

A multicenter, prospective, observational study enrolling 107 adult kidney transplant patients, Gielis et al.The results showed that GcfDNA above the threshold of 0.88% was significantly associated with acute rejection (AR), acute pyelonephritis, and acute tubular necrosis (P=0.017, P=0.032, P=0.011, Figure 1)3<\/sup>.<\/strong><\/p>\n

<\/strong><\/p>\n

Figure 1. Correlation of GcfDNA with AR and others<\/strong><\/p>\n

\n

\u00a0Another multicenter, prospective, observational study, which included 102 renal transplant patients, showed that GcfDNA distinguished rejection from non-rejection and ABMR from non-ABMR, with superior performance compared to blood creatinine (P<0.001 vs P=0.23, P<0.001 vs P=0.41, Figure 2, 3)4<\/sup>.<\/strong><\/p>\n

<\/strong><\/p>\n

Figure 2. GcfDNA and blood creatinine differentiate rejection from no rejection<\/strong><\/p>\n

<\/strong><\/p>\n

Figure 3. GcfDNA and blood creatinine distinguish ABMR from non-ABMR<\/strong><\/p>\n

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\u00a0 A single-center, prospective, observational study by Oellerich et al. that included 189 adult kidney transplant patients showed significantly higher levels of GcfDNA in biopsy-proven AR than in stable rejection-free patients (P < 0.0001, Figure 4).<\/p>\n

 <\/p>\n

\u00a0 The ROC curve of GcfDNA differentiating AR from stable phase without rejection showed significant significance (P=0.022, Figure 5), and<\/strong>Better identification accuracy (AUC=0.83)5<\/sup>.<\/p>\n

<\/p>\n

Figure 4. Comparison of GcfDNA levels after renal transplantation<\/p>\n

<\/p>\n

Figure 5. ROC curve of GcfDNA discriminating AR<\/p>\n

 <\/p>\n

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Summary<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n
\u00a0GcfDNA, as a new non-invasive biomarker, can be significantly elevated early in patients with rejection and has a high sensitivity and specificity for identification, which can be used for early prediction and identification of transplant rejection. At present, our company Jiankeng Medicine also carries out GcfDNA dynamic monitoring project, interested experts are welcome to leave a message or contact our team, we will reply promptly.<\/p>\n

 <\/p>\n

Reference:<\/p>\n

1.Di W, et al. Use of graft-derived cell-free DNA as a novel biomarker to predict allograft function after kidney transplantation. Int J Urol. 2021;28(10) ):1019-1025.<\/p>\n

2. Oellerich et al. Liquid biopsies: donor-derived cell-free DNA for the detection of kidney allograft injury. Nat Rev Nephrol . 2021;17(9):591-603.<\/p>\n

3. Gielis et al. The use of plasma donor-derived, cell-free DNA to monitor acute rejection after kidney transplantation. Nephrol Dial Transplant. 2020. 35(4):714-721.<\/p>\n

4. Bloom R D , et al. Cell-Free DNA and Active Rejection in Kidney Allografts. j Am Soc Nephrol. 2017;28(7):2221-2232.<\/p>\n

5. Oellerich et al. Absolute quantification of donor-derived cell-free DNA as a marker of rejection and graft injury in kidney transplantation: results from a prospective observational study. am J Transplant . 2019;19(11):3087-3099.<\/p>\n<\/section>\n<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"

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