Clinical Scorecard: Earlier Detection of Organ Rejection

At a Glance

Key Highlights

• dd-cfDNA testing offers noninvasive and sensitive detection of graft injury
• Rising dd-cfDNA levels can indicate acute rejection before serum chemistries or biopsy changes
• Next-generation sequencing and droplet digital PCR are the main analytical approaches
• Clinical applications are most established in kidney and heart transplantation
• dd-cfDNA may reduce unnecessary biopsies and improve monitoring strategies

Guideline-Based Recommendations

Diagnosis

• Measure serial dd-cfDNA in cases of graft dysfunction to assess for rejection

Management

• Incorporate dd-cfDNA into surveillance strategies for heart transplant patients

Monitoring & Follow-up

• Utilize dd-cfDNA for dynamic monitoring of graft health

Risks

• Emerging roles in liver and lung transplantation remain less definitive

Patient & Prescribing Data

Solid organ transplant recipients, especially those with graft dysfunction

dd-cfDNA testing can guide personalized surveillance and reduce invasive procedures

Clinical Best Practices

• Implement dd-cfDNA testing as part of routine transplant monitoring
• Standardize assays for more reliable molecular monitoring
• Utilize dd-cfDNA levels to differentiate between active rejection and stable graft function

References

• College of American Pathologists Review