Victoria Socha

DocwireNews

Despite advances in the modern era of kidney transplantation, the rates of allograft loss remain disproportionately higher among African American transplant recipients than among non-African American recipients. According to A. Langone and colleagues, biologic and socioeconomic risk factors are associated with the persistent racial <a href="https://www.docwirenews.com/docwire-pick/home-page-picks/what-are-heath-disparities-and-how-do-they-affect-the-united-states/">disparities</a> in outcomes. Donor derived-cell free DNA (dd-cfDNA), as a marker of cellular injury, has been shown to have value in risk stratification.The researchers conducted a study designed to compare the distribution of dd-cfDNA, stratified by self-reported race, to ascertain whether dd-cfDNA is a predictor of increased risk for allograft failure. Results of the study were reported during a virtual <a href="https://atcmeetingabstracts.com/abstract/value-of-dd-cfdna-when-considering-recipient-ethnicity-to-further-to-help-risk-stratify-transplant-recipients/">poster</a> session at the American Transplant Congress in a poster titled Value of dd-cfDNA When Considering Recipient Ethnicity to Further Help Risk Stratify Transplant Recipients.Patients in the DART (Diagnosing Active Rejection in Kidney&nbsp;Transplant&nbsp;Recipients) study were followed for 2 years. During the first year following kidney transplantation, dd-cfDNA (AlloSure&reg;, CareDx, Brisbane, California) was measured up to seven times. A total of 676 samples from African American patients were compared with 1307 samples from patients of other race/ethnicity. The researchers examined the cumulative distribution of dd-cfDNA in both cohorts.Compared with the non-African American cohort, patients in the African American cohort had significantly higher cumulative distribution of dd-cfDNA: mean 0.69 among African Americans versus 0.45 among non-African Americans, P=.0006. Events of allograft rejection were more frequent among African Americans than in the non-African American cohort (P=.0159).When considering the dd-cfDNA cumulative distribution function for the percentage change in estimated glomerular filtration rate (eGFR) stratified by race, African American patients had a significant improvement in eGFR compared with the non-African American patients following the clinical care intervention.In summary the researchers said, &ldquo;African American [ethnicity] is a significant risk factor for transplant recipients and is associated with an increase in dd-cfDNA. The regular use of dd-cfDNA as part of post-transplant surveillance may assist in the assessment and quantification of risk, and help allow earlier intervention to improve the overall outcomes and eGFR when events occur.&rdquo;Source: Langone A, Fischbach B, Cohen D. Value of dd-cfDNA when considering recipient ethnicity to further help risk stratify transplant recipients. Abstract of a poster presented at the virtual American Transplant Congress (Abstract B-323), May 30, 2020.

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Despite advances in the modern era of kidney transplantation, the rates of allograft loss remain disproportionately higher among African American transplant recipients than ...

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