An Initial Analysis of the Baseline Levels of Dd-cfDNA After Pancreas Transplantation: A Prospective Study From High-volume Centers in the United States

Yoo, Ashley; Riedel, Alexandria; Qian, Ian; Bartosic, Amanda; Soltani, Rudi; Kibria, Gulam Muhammed Al; Haririan, Abdolreza; Drachenberg, Cinthia B.; Abrams, Peter; Odorico, Jon S.; Cooper, Matthew; Bromberg, Jonathan S.; Scalea, Joseph R.

doi:10.1097/txd.0000000000001459

Cited by 4 publications

(2 citation statements)

References 38 publications

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“…Pancreas and kidney functions were evaluated at each post-operative visit and through regular laboratory screenings. We recorded the number of pancreas and renal transplant biopsies conducted, as well as the clinical reasons for performing them [19].…”

Section: Rejection Classification and Identificationmentioning

confidence: 99%

Pancreas Rejection in the Artificial Intelligence Era: New Tool for Signal Patients at Risk

Vigia

Ramalhete

Ribeiro

et al. 2023

JPM

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Introduction: Pancreas transplantation is currently the only treatment that can re-establish normal endocrine pancreatic function. Despite all efforts, pancreas allograft survival and rejection remain major clinical problems. The purpose of this study was to identify features that could signal patients at risk of pancreas allograft rejection. Methods: We collected 74 features from 79 patients who underwent simultaneous pancreas–kidney transplantation (SPK) and used two widely-applicable classification methods, the Naive Bayesian Classifier and Support Vector Machine, to build predictive models. We used the area under the receiver operating characteristic curve and classification accuracy to evaluate the predictive performance via leave-one-out cross-validation. Results: Rejection events were identified in 13 SPK patients (17.8%). In feature selection approach, it was possible to identify 10 features, namely: previous treatment for diabetes mellitus with long-term Insulin (U/I/day), type of dialysis (peritoneal dialysis, hemodialysis, or pre-emptive), de novo DSA, vPRA_Pre-Transplant (%), donor blood glucose, pancreas donor risk index (pDRI), recipient height, dialysis time (days), warm ischemia (minutes), recipient of intensive care (days). The results showed that the Naive Bayes and Support Vector Machine classifiers prediction performed very well, with an AUROC and classification accuracy of 0.97 and 0.87, respectively, in the first model and 0.96 and 0.94 in the second model. Conclusion: Our results indicated that it is feasible to develop successful classifiers for the prediction of graft rejection. The Naive Bayesian generated nomogram can be used for rejection probability prediction, thus supporting clinical decision making.

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Section: Rejection Classification and Identificationmentioning

confidence: 99%

Pancreas Rejection in the Artificial Intelligence Era: New Tool for Signal Patients at Risk

Vigia

Ramalhete

Ribeiro

et al. 2023

JPM

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“…In another study, Williams et al [ 25 ] found that levels of circulating donor cell-free DNA are significantly lower in stable recipients and even those with pancreatitis compared to patients who experienced acute rejection. Researchers in Barcelona explored donor circulating DNA as a diagnostic biomarker before biopsy, finding that assessment of donor-derived DNA 45 days after transplant had the highest specificity and sensitivity to predict acute rejection in biopsy results compared to typical markers like amylase and lipase [ 26 ]. Similarly, multicenter study including SPKT and pancreas transplantation alone (PTA) showed that dd-cfDNA is elevated within 3 months after transplant, regardless of the type of transplantation and presence of infection or rejection [ 27 ].…”

Section: Pancreas Transplantationmentioning

confidence: 99%

Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ Transplantation

et al. 2023

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A number types of extracellular DNA (eg, cell-free, cfDNA) circulate in human blood, including mitochondrial, transcriptome, and regulatory DNA, usually at low concentrations. Larger amounts of cfDNA appear in any inflammatory condition, including organ damage due to a variety of reasons. The role of cfDNA in solid organ transplantation is discussed in this review as a valuable additional tool in the standard of care of transplant patients. Post-transplant monitoring requires the use of high-quality biomarkers for early detection of graft damage or rejection to be able to apply early therapeutic intervention. CfDNA complements the traditional monitoring strategies, being a risk stratification tool and an important prognostic marker. However, improving the sensitivity and specificity of cfDNA detection is necessary to facilitate personalized patient management, warranting further research in terms of measurement, test standardization, and storage, processing, and shipping. A diagnostic test (Allosure, CareDx, Inc., Brisbane, CA) for kidney, heart and lung transplant patients is now commercially available, and validation for other organs (eg, liver) is pending. To date, donor-derived cfDNA in combination with other biomarkers appears to be a promising tool in graft rejection as it is minimally invasive, time-sensitive, and cost-effective. However, improvement of sensitivity and specificity is required to facilitate personalized patient management. Whether it could be an alternate to graft biopsy remains unclear.

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Banff 2022 pancreas transplantation multidisciplinary report: Refinement of guidelines for T cell–mediated rejection, antibody-mediated rejection and islet pathology. Assessment of duodenal cuff biopsies and noninvasive diagnostic methods

Drachenberg,

Buettner-Herold,

Aguiar

et al. 2024

American Journal of Transplantation

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An Initial Analysis of the Baseline Levels of Dd-cfDNA After Pancreas Transplantation: A Prospective Study From High-volume Centers in the United States

Cited by 4 publications

References 38 publications

Pancreas Rejection in the Artificial Intelligence Era: New Tool for Signal Patients at Risk

Pancreas Rejection in the Artificial Intelligence Era: New Tool for Signal Patients at Risk

Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ Transplantation

Banff 2022 pancreas transplantation multidisciplinary report: Refinement of guidelines for T cell–mediated rejection, antibody-mediated rejection and islet pathology. Assessment of duodenal cuff biopsies and noninvasive diagnostic methods

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