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Indian Journal of Thoracic and Cardiovascular Surgery
Published in: Indian Journal of Thoracic and Cardiovascular Surgery 3/2021

01-05-2021 | Heart Transplantation | ORIGINAL ARTICLE

Cell-free DNA in the surveillance of heart transplant rejection

Authors: Dhruva Sharma, Ganapathy Subramaniam, Neha Sharma, Preksha Sharma

Published in: Indian Journal of Thoracic and Cardiovascular Surgery | Issue 3/2021

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Abstract

Background

Circulating cell-free deoxyribonucleic acid (cfDNA) is promptly materializing as a highly useful tool for the surveillance of solid-organ transplant rejection. Donor-specific fraction (DF) cfDNA is a potential marker of selective donor organ injury. It is emerging as a promising analytical target in the near future. The aim of this systematic review is to throw light on the importance of cfDNA and future perspective in detecting acute rejection in heart transplantation.

Methods

An exhaustive search was carried out for this review article on the basis of literature available including scientific databases of PubMed, Embase, and ClinicalTrials.​gov. The search engines were systematically explored using the search terms “cell free DNA,” “Heart transplant,” and “Rejection” from inception until August 2020, and narrative analysis was accomplished. Majority of the studies described endomyocardial biopsy-proven acute rejection as reference standard.

Results

After initial screening of 331 articles, 11 studies were included and discussed in detail in the present review article. Majority of the studies showed prospective designs. A firm correlation was noted between acute rejection (identified on endomyocardial biopsy) and cfDNA levels by most of the studies.

Conclusions

cfDNA is a promising tool to replace repeated biopsies to detect rejection. The development in the area of digital droplet polymerase chain reaction and massive parallel sequencing, along with the overall reduction in cost of sequencing with its automation, has helped establish its role in the transplant population.
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Metadata
Title
Cell-free DNA in the surveillance of heart transplant rejection
Authors
Dhruva Sharma
Ganapathy Subramaniam
Neha Sharma
Preksha Sharma
Publication date
01-05-2021
Publisher
Springer Singapore
Published in
Indian Journal of Thoracic and Cardiovascular Surgery / Issue 3/2021
Print ISSN: 0970-9134
Electronic ISSN: 0973-7723
DOI
https://doi.org/10.1007/s12055-020-01130-9

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