ArticleTransplantation direct2021
Utility of Serial Donor-derived Cell-free DNA Measurements for Detecting Allograft Rejection in a Kidney Transplant Recipient After PD-1 Checkpoint Inhibitor Administration.
Article in Transplantation direct, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 15 citations in OpenAlex.
- Growth and development following paediatric kidney transplantation: Mechanisms, influencing factors, and clinical management.World journal of transplantation · 2026Review
- Early Donor-Derived Cell-Free DNA Kinetics After Kidney Transplantation in Atypical Hemolytic Uremic Syndrome: A Preliminary Observational Study.International journal of molecular sciences · 2026Observational
- Requiring Caution in the Interpretation of Donor-Derived Cell-Free DNA Levels During Cancer Treatment in a Kidney Transplant Recipient.: A Case Report.IJU case reports · 2026Article
- Ten tips on how to prevent and manage post-transplant lymphoproliferative disease in kidney transplant recipients.Clinical kidney journal · 2026Review
- Post-transplant hepatocellular carcinoma: balancing immunosuppression and immune checkpoint inhibitors.Clinical and molecular hepatology · 2026Review
- Diagnostic Test Accuracy of Detecting Donor-Derived Cell-Free DNA in Renal Transplant Rejection: A Systematic Review and Meta-Analysis.Journal of transplantation · 2026Review
- Merkel cell carcinoma in solid organ transplant recipients: prognosis and response to immunotherapy.The British journal of dermatology · 2025Article
- Review
- Donor-derived cell-free DNA-based liquid biopsies to determine future kidney transplant rejection.Kidney research and clinical practice · 2025Article
- Case Report: Metastatic small bowel adenocarcinoma with DNA mismatch repair deficiency in an organ transplant recipient treated with anti-PD-1 immunotherapy.Frontiers in oncology · 2025Article
- Nivolumab + Tacrolimus + Prednisone ± Ipilimumab for Kidney Transplant Recipients With Advanced Cutaneous Cancers.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Article
- Use of immune checkpoint inhibitors in solid organ transplant recipients with advanced cutaneous malignancies.Frontiers in transplantation · 2023Article
- Immune checkpoint inhibitors for solid organ transplant recipients: clinical updates.Korean journal of transplantation · 2022Review
- Transplant Onconephrology in Patients With Kidney Transplants.Advances in chronic kidney disease · 2022Review
- Donor Derived Cell Free DNA in Kidney Transplantation: The Circa 2020-2021 Update.Transplant international : official journal of the European Society for Organ Transplantation · 2022Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundDonor-derived cell-free DNA (dd-cfDNA) is a useful biomarker of rejection that originates from allograft cells undergoing injury. Plasma levels <1% in kidney transplant recipients have a high negative predictive value for active allograft rejection. The utility of this biomarker in kidney transplant recipients receiving immune checkpoint inhibitor therapy is unknown.
methodsWe describe a case in which serial dd-cfDNA monitoring facilitated the use of immune checkpoint inhibitor therapy, which is known to be associated with high rates of rejection, in a kidney transplant recipient with metastatic cancer.
resultsA 72-y-old man with end-stage kidney disease secondary to autosomal dominant polycystic kidney disease underwent living unrelated kidney transplant in December 2010. His immunosuppression regimen included tacrolimus, mycophenolate, and prednisone. In July 2017, he presented with metastatic cutaneous squamous cell carcinoma. After his disease progressed through radiation therapy and cetuximab, he received pembrolizumab (antiprogrammed cell death protein 1). His dd-cfDNA level was undetectable at baseline, then increased during treatment but remained <1%. This trend, despite fluctuations in serum creatinine levels during therapy, allowed for continuation of pembrolizumab and successful treatment of his metastatic cancer without clinically evident allograft rejection. After discontinuation of pembrolizumab, dd-cfDNA levels fell below the level of detection. Genetic analysis of the cutaneous squamous cell carcinoma demonstrated a genetic profile distinct from the dd-cfDNA, indicating that tumor lysis did not impact increases in dd-cfDNA.
conclusionsSerial dd-cfDNA measurements may provide a useful, noninvasive biomarker for detecting allograft injury that may facilitate the use of immunomodulatory therapies in organ transplant recipients with cancer.
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Registered trials
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.