Subclinical non-HLA AMR detection and monitoring with surveillance dd-cfDNA in a kidney transplant recipient

Abstract

Elevations in dd-cfDNA at the time of kidney allograft dysfunction are associated with an increased risk of rejection. The utility of such measurements in a stable allograft is unknown. Herein we present a case utilizing routine surveillance dd-cfDNA to detect subclinical active BANFF rejection with persistent elevations and biopsy evidence of ongoing injury despite treatments. Due to treatment failure she developed chronic allograft nephropathy within six months of transplantation. Surveillance and post treatment monitoring of dd-cfDNA may be useful early detection and monitoring of rejection in kidney transplant recipients and as a marker in future studies.