The mTOR You Know
Decoding donor-derived cell-free DNA (dd-cfDNA)
What does an elevated dd-cfDNA actually mean—and what doesn’t it mean? In this episode of mTOR You Know , Lauren Schumacher and Kimberly Leale sit down with Dr. Adele Shields and Dr. James Fleming to get into the practical side of using donor-derived cell-free DNA in solid organ transplantation. We talk through how to interpret results, when dd-cfDNA is most useful, common pitfalls and things we might be tempted to over-interpret, how it fits alongside other tools for assessing allograft injury, and what we still need to learn. Plus, we dig into where pharmacists fit into all of this and where the field might be headed next. Currently approved dd-cfDNA tests: CareDx (AlloSure) : Kidney + SPK: AlloSure Kidney Heart: AlloSure Heart Lung: AlloSure Lung Natera (Prospera): Kidney: Prospera Kidney Heart: Prospera Heart with DQS – dd-cfDNA combined with Donor Quantity Score (DQS) Lung: Prospera Lung Liver: Prospera Liver Transplant Genomics/Eurofins Kidney: TRAC Liver: OmniGraf – dd-cfDNA combined with gene expression Not to be confused with rejection gene expression assays: Kidney: TruGraf – Transplant Genomics Liver: OmniGraf – Transplant Gemonics Heart: AlloMap - CareDx
