Evidence map›Paper›PMID 32056331›Full record

ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2020

High levels of dd-cfDNA identify patients with TCMR 1A and borderline allograft rejection at elevated risk of graft injury.

Erik Stites, Dhiren Kumar, Oyedolamu Olaitan, Sidney John Swanson, Nicolae Leca, Matthew Weir, Jonathan Bromberg, Joseph Melancon, Irfan Agha, Hasan Fattah and 4 more

Abstract read
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In one paragraph

Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
75citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

75 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Donor-Derived Cell-Free DNA (dd-cfDNA) in Kidney Transplant Recipients With Indication Biopsy-Results of a Prospective Single-Center Trial.Transplant international : official journal of the European Society for Organ Transplantation · 2023
    Trial
  4. Observational
  5. Article
  6. Review
  7. Article
  8. Article
  9. Review
  10. Review
  11. Longitudinal Monitoring of Donor-Derived Cell-Free DNA Supports Risk Stratification in Kidney Transplant Recipients With Allograft Dysfunction.Transplant international : official journal of the European Society for Organ Transplantation · 2026
    Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. Noninvasive Diagnosis of Kidney Allograft Rejection.Journal of the American Society of Nephrology : JASN · 2025
    Review
  17. Review
  18. Article
  19. Article
  20. Article

15 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Erik StitesUniversity of Colorado HSC, Aurora, Colorado, USA.
Dhiren KumarMedicine/Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.ORCID 0000-0002-6816-9297
Oyedolamu OlaitanDepartment of Surgery, Rush Medical College, Chicago, Illinois, USA.
Sidney John SwansonChristiana Care Health Services, Wilmington, Delaware, USA.
Nicolae LecaDivision of Nephrology, Department of Medicine, University of Washington Medical Center, Seattle, Washington, USA.
Matthew WeirDivision of Nephrology, University of Maryland, Baltimore, Maryland, USA.
Jonathan BrombergUniversity of Maryland School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0002-1407-8795
Joseph MelanconSurgery, George Washington University, Washington, District of Columbia, USA.ORCID 0000-0002-8673-7454
Irfan AghaMedical City Dallas Hospital, Dallas, Texas, USA.
Hasan FattahUniversity of Kentucky Medical Center, Lexington, Kentucky, USA.
Tarek AlhamadWashington University in Saint Louis, Saint Louis, Missouri, USA.ORCID 0000-0003-4289-0817
Yasir QaziKeck School of Medicine, University of Southern California, Los Angeles, California, USA.
Alexander WisemanUniversity of Colorado HSC, Aurora, Colorado, USA.
Gaurav GuptaMedicine/Nephrology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.ORCID 0000-0003-1919-1970

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The clinical importance of subclinical, early T cell-mediated rejection (Banff TCMR 1A and borderline lesions) remains unclear, due, in part to the fact that histologic lesions used to characterize early TCMR can be nonspecific. Donor-derived cell-free DNA (dd-cfDNA) is an important molecular marker of active graft injury. Over a study period from June 2017 to May 2019, we assessed clinical outcomes in 79 patients diagnosed with TCMR 1A/borderline rejection across 11 US centers with a simultaneous measurement of dd-cfDNA. Forty-two patients had elevated dd-cfDNA (≥0.5%) and 37 patients had low levels (<0.5%). Elevated levels of dd-cfDNA predicted adverse clinical outcomes: among patients with elevated cfDNA, estimated glomerular filtration rate declined by 8.5% (interquartile rate [IQR] -16.22% to -1.39%) (-3.50 mL/min/1.73 m

Indexed as

Cell-Free Nucleic AcidsKidney TransplantationAllograftsGraft RejectionHumansTissue DonorsCell-Free Nucleic Acidsbiomarkercellular transplantation (non-islet)clinical research/practicekidney (allograft) function/dysfunctionkidney failure/injurymonitoring: immunerejection: T cell mediated (TCMR)

Identifiers

PMID32056331
PMCPMC7496411

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.