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血总和来自供体的无细胞DNA预测了移植受体的存活率

Alison S Graver^1,2,3,4, David A Power^1,2, John B Whitlam^1,2,3,4

¹Department of Medicine, University of Melbourne, Parkville, VIC, Australia.

Frontiers in transplantation

|September 17, 2025

概括

血细胞自由DNA (cfDNA) 水平可以预测移植受体的长期结果. 高总cfDNA和低分数的捐赠者衍生的cfDNA (ddcfDNA) 预测死亡,而高分数的ddcfDNA预测移植损失.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
移植免疫学移植免疫学
分子诊断学分子诊断学

背景情况:

无细胞DNA (cfDNA) 分析正在出现用于移植功能障碍.
供体衍生cfDNA (ddcfDNA) 主要用于排斥检测.
在移植接受者 (KTRs) 中,cfDNA对长期结果的预后价值仍未得到充分研究.

研究的目的:

为了研究血总cfDNA,分数ddcfDNA和绝对ddcfDNA的预后价值,在KTRs中具有异位移植功能障碍.
评估这些cfDNA标记与长期生存结果的关联:死亡,死亡审查的移植损失 (DCGL) 和全部移植损失 (AGL).

主要方法:

在49个成年KTR中量化血总cfDNA,分数ddcfDNA和绝对ddcfDNA,在指示时进行全移植活检.
随访患者的中位数为6.3年,以记录主要结果.
使用单变量和多变量分析来确定预后关联.

主要成果:

高总cfDNA (>4,034副本/毫升) 预测死亡 (HR 5.94) 和所有移植损失 (AGL) (HR 642).
低分数的ddcfDNA (<0.67%) 预测了死亡 (HR 10.85).
高分数的ddcfDNA (>0.72%) 预测了死亡审查的移植损失 (DCGL) (HR 4.93). 绝对ddcfDNA显示没有与生存结果的关联.

结论:

血总cfDNA和分数ddcfDNA显示了KTRs与异位移植功能障碍的预后效用.
这些cfDNA标记物可能会增强个性化护理,超越非侵入性拒绝检测.
进一步的研究可以将这些生物标志物整合起来,以改善KTR管理和预测长期的移植生存.

关键词:

没有细胞的DNAcfDNADNA ddcfDNADNA 在线观看腎臟移植腎臟移植预后生物标志物预后生物标志物幸存率幸存率生存率

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