Research ArticleGenomics

Circulating Cell-Free DNA Enables Noninvasive Diagnosis of Heart Transplant Rejection

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Science Translational Medicine  18 Jun 2014:
Vol. 6, Issue 241, pp. 241ra77
DOI: 10.1126/scitranslmed.3007803

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Donor DNA Indicates Transplant Rejection

Not all heart transplants succeed, but early detection of organ rejection could spare the patient severe adverse events and graft dysfunction. De Vlaminck et al. devised a noninvasive, sequencing-based method to monitor and predict rejection, relying on the presence of donor DNA in recipient blood plasma. The fraction of donor DNA is naturally elevated 1 day after transplant (because organ transplants are essentially genome transplants), and these levels decline exponentially over the course of the week, if the organ is accepted. The authors noted that patients who rejected their new heart had high levels of donor DNA even months after transplant. In a prospective trial, elevated donor DNA was detected months before the rejection episode, suggesting that such noninvasive analysis tools could be used in lieu of an invasive biopsy, to let doctors know which patients are likely to reject their transplanted organ.