A Biopsy-Free Future: Science Fiction or Science Reality?
JACC Heart Fail. 2025 Nov 21:102782. doi: 10.1016/j.jchf.2025.102782. Online ahead of print.
NO ABSTRACT
PMID:41273317 | DOI:10.1016/j.jchf.2025.102782
JACC Heart Fail. 2025 Nov 21:102782. doi: 10.1016/j.jchf.2025.102782. Online ahead of print.
NO ABSTRACT
PMID:41273317 | DOI:10.1016/j.jchf.2025.102782
Chest. 2025 Sep;168(3):581-583. doi: 10.1016/j.chest.2025.04.023.
NO ABSTRACT
PMID:40935546 | DOI:10.1016/j.chest.2025.04.023
Eur Respir J. 2025 Jul 31:2402537. doi: 10.1183/13993003.02537-2024. Online ahead of print.
ABSTRACT
BACKGROUND: Allograft injury in the early post-transplant period is a known risk factor of death after lung transplantation. However, the recipient tissue injury profile and its association with outcomes remain unexplored. This study leverages cell-free DNA (cfDNA) to test this association.
METHODS: The prospective cohort multicenter study included lung transplant recipients (GRAfT, NCT02423070) with serial plasma measurements of recipient-derived (rd)-cfDNA using digital droplet PCR. Non-transplant healthy controls were recruited as the comparator. Whole-genome bisulfite sequencing identified tissue sources of cfDNA. Mean rd-cfDNA levels within 30 days post-transplant was computed. Multivariable regression models were used to assess the association between rd-cfDNA tertiles and the primary outcome of death and secondary outcomes.
RESULTS: The study included 215 patients with 2530 cfDNA values, including 675 cfDNA assessments in the first 30 days. Median rd-cfDNA levels in the first 30 days post-transplant were βΌ16-fold higher than cfDNA for healthy controls. Patients in the highest tertile rd-cfDNA group had lower lung function post-transplant, and increased risk of death (HR: 3.15, 95% CI: 1.59-6.24, p<0.001) and acute rejection (HR 2.33, 95% CI: 1.33-4.08, p=0.03), compared to the low/middle tertile group. Tissue-specific cfDNA sources were also distinct cfDNA in the highest versus lowest rd-cfDNA tertiles, with cfDNA from innate immune cells serving as the strongest predictor of mortality.
CONCLUSION: Post-transplant recipient tissue injury varies between lung transplant patients and is associated with increased risk of acute rejection and mortality.
PMID:40744691 | DOI:10.1183/13993003.02537-2024