Evidence map›Paper›PMID 41972229›Full record

ArticleTransplantation direct2026

Donor-derived Cell-free DNA for Detection of Rejection After Pancreas Transplantation.

Abraham J Matar, Samy Riad, Heidi Sarumi, Michael G Megaly, Matthew Wright, Erik Finger, Vanessa Humphreville, Karthik Ramanathan, Jessica Fisher, Joseph S Rao and 4 more

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Article in Transplantation direct, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Abraham J MatarDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN.ORCID https://orcid.org/0000-0001-7351-7674
Samy RiadDivision of Nephrology, Department of Medicine, Mayo Clinic, Rochester, MN.
Heidi SarumiDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN.
Michael G MegalyDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN.
Matthew WrightDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN.
Erik FingerDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN.
Vanessa HumphrevilleDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN.
Karthik RamanathanDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN.
Jessica FisherDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN.
Joseph S RaoDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN.
Zachary DemkoNatera, Inc, San Carlos, CA.
Adam PrewettNatera, Inc, San Carlos, CA.
Hossein TabrizianiNatera, Inc, San Carlos, CA.
Raja KandaswamyDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Donor-derived cell-free DNA (dd-cfDNA) has emerged as a promising noninvasive biomarker for detecting allograft rejection in solid organ transplantation. However, its diagnostic utility in pancreas transplantation, including in multiorgan recipients, remains underexplored. Methods: We conducted a retrospective analysis of 42 pancreas transplant recipients (38 simultaneous pancreas-kidney, 4 pancreas transplant alone) who underwent for-cause organ biopsy and dd-cfDNA testing between April 2020 and December 2024. dd-cfDNA was measured using the Prospera assay, with a threshold of ≥1% considered high risk and <1% low-risk. Biopsy results were correlated with dd-cfDNA to assess test performance. Results: A total of 50 dd-cfDNA tests and 45 organ biopsies were analyzed. Among simultaneous pancreas-kidney recipients, dd-cfDNA demonstrated a sensitivity of 86.7%, specificity of 52.2%, positive predictive value (PPV) of 54.2%, and negative predictive value (NPV) of 85.7% for rejection. In pancreas transplant alone recipients, all high-risk dd-cfDNA results corresponded to biopsy-proven rejection, yielding 100% sensitivity, specificity, PPV, and NPV. When combining both cohorts, dd-cfDNA testing achieved an overall sensitivity of 88.2%, specificity of 57.7%, PPV of 57.7%, and NPV of 88.2%. Additionally, dd-cfDNA kinetics suggested its potential utility as a surveillance tool posttreatment, potentially reducing the need for closure biopsies. Conclusions: dd-cfDNA is a valuable noninvasive adjunct for monitoring of rejection in pancreas transplant recipients. Further prospective studies are needed to validate these findings and define the optimal role of dd-cfDNA in posttransplant care.

Identifiers

PMID41972229
PMCPMC13065230

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