European journal of molecular biology and biochemistry

DONOR DERIVED cfDNA IS A NEW INVESTIGATIVE TOOL FOR DETECTION OF GRAFT REJECTION AND ASYMPTOMATIC GRAFT INJURY IN ORGAN TRANSPLANTATION

Dr Pamu Shiva Ramulu, Dr Vijaya Karra, Dr Boinapalli Sudhakar

boinapallisudhakar@gmail.com

Immunosuppression, Organ transplantation, cfDNA, Graft rejection, Asymptomatic graft injury

There is a very important requirement of personalized superior immunosuppression in the field of organ transplantation to minimize premature graft loss. Proficient markers are needed in order to predict rejection and asymptomatic graft injury in organ transplant patients who are under the immunosupression. Prevention of immune activation and exposure to guide tapering are minimal needs for assessment. Allograft integrity is comprehensively monitored with the help of Donor derived cell free DNA [dd-cfDNA]. This review helps to known about prospective benefits of dd-cfDNA to stakeholders [transplant physician, patient, hospital management, laboratory medicine specialist, insurance companies] involved in solid organ transplantation care. There are ninety five articles which contributes strong evidence from forty seven studies shows the role of ddcfDNA for detection of graft rejection and for monitoring graft integrity. The majority studies are prospective and retrospective cohort studies. There are many techniques used to measure dd-cfDNA in which many of them does not require donor sample. The baseline levels of dd-cfDNA vary by organ type and its normal levels falls rapidly within 2 weeks. The dd-cfDNA levels are elevated in the presence of allograft injury, acute rejections, and infections and returns to normal level after effective treatment. It also have been demonstrated that dd-cfDNA testing is essential for directing potential transplant injury interventions in advance for enhanced long-term result. In contrast with tissue biopsies, ddcfDNA present in blood offers a rapid and reproducible method to identify graft injuries at early stage and permits more effective personalized immunosuppression. Cell free DNA is novel marker for monitoring health status of solid organ transplant recipients. It can be used in routine clinical practice and have significant clinical outcome with prospective monitoring