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Wenjia Di, Qing Ran, Hongji Yang, Jun Lu, Yifu Hou, Xiaoxiao Wang, Jiayang He, Liang Wei

Jul 6, 2021
International Journal of Urology
Article Institutional access

Objective To investigate the association between graft‐derived cell‐free DNA and pretransplantation clinical variables, and to determine whether the former could be used as a novel biomarker to predict renal function.
Method A total of 87 recipients who underwent primary kidney transplantation were recruited to the study. For each recipient, 10 mL peripheral blood was collected on days 1, 7, 14–20, and 30–45 after transplantation. The fractional abundance of graft‐derived cell‐free DNA was determined using droplet digital polymerase chain reaction.
Result For most recipients, graft‐derived cell‐free DNA fraction values were significantly elevated on the first day after transplantation, followed by a rapid decline, and reaching baseline values of graft‐derived cell‐free DNA fraction in the range of <1% at 7 days. Statistical analysis showed that longer cold ischemia time was significantly associated with higher graft‐derived cell‐free DNA fraction values (P = 0.02). Moreover, we also found that graft‐derived cell‐free DNA fraction values among recipients with delayed graft function were significantly higher than those of recipients without delayed graft function on the first day after transplantation. Kaplan–Meier analysis showed that recipients who had a graft‐derived cell‐free DNA fraction value of <1% at 7 days had a significantly lower probability of an estimated glomerular filtration rate ≤60 mL/min/1.73 m2 at 90 days. Using a random forest regression model, the predicted values of estimated glomerular filtration rate at 90 days were almost the same as the actual values.
Conclusions Our findings suggest that graft‐derived cell‐free DNA might be used as a novel biomarker to predict delayed graft function and renal function.

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