Donor-derived Cell-free DNA in Infections in Kidney Transplant Recipients: Case Series
Naeem Goussous, Wen Xie, Noor Dawany, Joseph R. Scalea, Amanda Bartosic, Abdolreza Haririan, Roberto Kalil Filho, Cinthia B. Drachenberg, Nadiesda Costa, Matthew R. Weir, Jonathan S. Bromberg
Abstract
BACKGROUND: Donor-derived cell-free DNA (dd-cfDNA) is a noninvasive plasma biomarker to evaluate for transplant allograft rejection. The relationship between infectious complications in kidney allografts and dd-cfDNA has received cursory attention in prior publications. METHODS: Retrospective review of all renal transplant recipients who underwent dd-cfDNA testing between November 2017 and August 2019. RESULTS: We report on 7 cases in whom infections affecting the transplanted kidney were associated with elevation in dd-cfDNA without concomitant rejection or elevation in serum creatinine. Five patients had BK viremia, and 2 patients had urinary tract infection associated with elevated dd-cfDNA levels. CONCLUSIONS: These observations suggest that elevations in dd-cfDNA are not specific to kidney allograft rejection and can be associated with infections affecting the transplanted kidney. This biomarker may be valuable in evaluating infectious complications of kidney allografts.