ArticleFrontiers in medicine2026
Validation of the TransplantTrace cfDNA Kidney assay for measurement of donor-derived cell-free DNA in transplant recipients.
Article in Frontiers in medicine, 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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Abstract
Introduction: Donor-derived cell-free DNA (dd-cfDNA) has emerged as a promising non-invasive marker for assessing allograft status and guiding clinical management in transplant recipients. Its utility in kidney transplantation has repeatedly been demonstrated in large studies showing a strong association between elevated dd-cfDNA levels and allograft injury or rejection. This study evaluated the performance of a centralized next-generation sequencing (NGS)-based assay for measurement of dd-cfDNA in patients post-kidney transplantation. Methods: The TransplantTrace cfDNA Kidney assay utilizes 50 insertion-deletion (indel) markers to discriminate dd-cfDNA. Evaluation of analytical performance included determination of input requirements, analytical sensitivity and specificity, as well as accuracy and precision parameters. Diagnostic performance was evaluated in a retrospective cohort of 104 post-transplantation samples by comparing dd-cfDNA results with biopsy-confirmed rejection. Results: The assay required low DNA input (2 ng) and demonstrated high analytical sensitivity, with a verified limit of detection of 0.2% and limit of quantification of 0.3% dd-cfDNA. Analytical accuracy was excellent ( Conclusion: The TransplantTrace cfDNA Kidney assay demonstrated robust analytical performance and strong clinical concordance with biopsy-confirmed rejection status. Its high diagnostic accuracy supports reliable identification and exclusion of active rejection, with the potential to reduce reliance on invasive biopsy procedures in patients with elevated serum creatinine but low dd-cfDNA levels. In summary, the findings of this study support the implementation and use of this centralized assay for measurement of dd-cfDNA in patients post-kidney transplantation.
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