Korean J Transplant.  2022 Nov;36(Supple 1):S325. 10.4285/ATW2022.F-4655.

Serial changes of donor-derived cell-free DNA in recipients of pancreas transplants

• Lee HJ
• Shin KH
• Choi BH
• Kim HH

• KMID: 2535552
• DOI: http://doi.org/10.4285/ATW2022.F-4655

Abstract

Background
The transplant rejection reaction is validated with an organ biopsy if transplant rejection occurs after transplantation in the early stages following transplantation. According to the notion that DNA fragments from transplanted organs per- sist in the recipient's plasma as cell free DNA, it has been observed that if acute rejection occurs, donor-derived cell free DNA (ddcfDNA) increases. The aim of this study was to investigate the pattern of ddcfDNA changes in pancreas transplant recipients following transplantation.
Methods
This was a prospective, observational study in patients who underwent pancreatic transplant from December 2016 to August 2017. In total 14 patients were underwent transplantation, of which five patients were included in this study. From five patients, samples were obtained according to the study protocol at postoperative day (POD) 4, 7, 14, 30, 60, 90, and 120–180. Serum samples were tested: amylase, lipase, tacrolimus. Plasma samples were tested for donor derived cell free DNA. The study protocol was reviewed and approved by the Institutional Review Board of Pusan National University Yangsan Hospital (IRB No. 05-2019-006) and written informed consent was obtained from all participants.
Results
The median age of the patients was 35 years. Of the five pancreatic transplant patients, one (20.0%) had T-cell mediated rejection (TCMR) episode. The median percentage (range) of the ddcfDNA for POD 4, 7, 14, 30, 60, 90, and 180 were 2.7 (0.4–5.5), 0.6 (0.2–4.4), 3.7 (0.4–12.7), 7.1 (0.4–7.9), 2.1 (0.1–5.4), 2.0 (0.3–8.5), and 0.3 (0.2–7.6). The median amylase (range) for POD 4, 7, 14, 30, 60, 90, and 180 were 68.0 (30.0–80.0), 82.0 (57.0–151.0), 74.0 (66.0–157.0), 81.0 (50.0–137.0), 74.0 (39.0–111.0), 80.0 (27.0–98.0), and 80.0 (43.0–105.0). The ddcfDNA value of POD14 in patients who developed TCMR on POD 530 was higher than 10%.
Conclusions
The ddcfDNA levels remained elevated for 2 weeks following transplantation in patients with TCMR.