MP32-10 NONINVASIVE RENAL TRANSPLANT GRAFT MONITORING IN A SINGLE INSTITUTION USING CELL-FREE DONOR NUCLEIC ACID IN RECIPIENT PLASMA VIA INSERTION-DELETION ALLELE POLYMORPHISM

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery II1 Apr 2016MP32-10 NONINVASIVE RENAL TRANSPLANT GRAFT MONITORING IN A SINGLE INSTITUTION USING CELL-FREE DONOR NUCLEIC ACID IN RECIPIENT PLASMA VIA INSERTION-DELETION ALLELE POLYMORPHISM Yen Seow Benjamin Goh, Sze Yee Sherry Ho, Yi Quan Tan, Lata Raman, Vathsala Anantharaman, Ting Hui Angeline Goh, Siew Chuan Evelyn Koay, and Ho Yee Tiong Yen Seow Benjamin GohYen Seow Benjamin Goh More articles by this author , Sze Yee Sherry HoSze Yee Sherry Ho More articles by this author , Yi Quan TanYi Quan Tan More articles by this author , Lata RamanLata Raman More articles by this author , Vathsala AnantharamanVathsala Anantharaman More articles by this author , Ting Hui Angeline GohTing Hui Angeline Goh More articles by this author , Siew Chuan Evelyn KoaySiew Chuan Evelyn Koay More articles by this author , and Ho Yee TiongHo Yee Tiong More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1305AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal transplantation is the optimal and most cost-effective treatment of end-stage renal failure. 64% of renal allograft failure is biopsy-proven to result from rejection leading to catastrophic recipient morbidity and loss of precious donor kidneys. There is an unmet clinical need in early detection of donor organ tissue damage before irreversible, non-specific renal function deterioration (by means of serum creatinine) and use of invasive allograft biopsy. Cell-free donor DNA(cfdDNA) had been explored in cancer detection, prenatal diagnostics and solid organ transplants worldwide, albeit limited to sex-mismatched donor-recipients. Gender-independent insertion-deletion (INDELs) polymorphic sequences were applied for noninvasive prenatal testing at the hospital Molecular Diagnostic Centre (MDC) with high sensitivity. The 8 identified INDELs were analysed in our donor recipient pairs Aim - Detect cfdDNA in recipient plasma using real-time polymerase chain reaction (qPCR) - Monitor the trend, peak and troughs of cfdDNA METHODS 10 Han Chinese donor-recipient pairs undergoing living related renal transplant were prospectively recruited and consented from National University Centre for Organ Transplant. Immunosuppression regimen is per protocol, managed by renal physicians Donor blood sampling performed once prior to transplant. Recipient blood sampling performed daily while inpatient and processed in MDC as per protocol Institution review board approved study RESULTS 1 or more informative INDELs detected in 9 of 10 recipients post transplant. Where the informative INDEL was multiplexed with an INDEL present in both donor and recipient DNA, percentages of the former can be calculated The cfdDNA levels rose sharply to peak at post operative Day 1-2 and decreased to a trough by Day 3-6(refer to chart) CONCLUSIONS INDEL polymorphism is a plausible mechanism to detect cfdDNA in recipient plasma post renal transplant cfdDNA has been shown to spike with insults to donor graft. Current results have achieved a proof of concept and demonstrate ability of the this novel technique to potentially monitor graft health Future directions include correlation of cfDNA with long term graft outcome and peak level with various graft insults © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e431-e432 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Yen Seow Benjamin Goh More articles by this author Sze Yee Sherry Ho More articles by this author Yi Quan Tan More articles by this author Lata Raman More articles by this author Vathsala Anantharaman More articles by this author Ting Hui Angeline Goh More articles by this author Siew Chuan Evelyn Koay More articles by this author Ho Yee Tiong More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...