BACKGROUND:Pregnant kidney transplant recipients (KTRs) are a vulnerable, high-risk population, susceptible to obstetrical complications, as well as graft rejection. Current methods used to monitor kidney transplant function lack specificity. Recently, donor derived cell-free DNA (dd-cfDNA) has emerged as a non-invasive biomarker for assessing risk for allograft rejection in KTRs. However, utilizing dd-cfDNA to monitor allograft status in pregnant KTRs requires the ability to distinguish between fetal/placental, donor, and KTR derived cfDNA.
METHODS:We developed a custom bioinformatics analysis to identify and measure dd-cfDNA in 6 pregnant KTRs by sequencing maternal cfDNA (blood sample) and paternal genomic DNA (buccal swab).
RESULTS:We demonstrate our ability to successfully measure dd-cfDNA in 4/6 pregnant KTRs.
CONCLUSIONS:This proof-of-concept study demonstrates that dd-cfDNA can be measured in pregnant KTRs. This study lays the foundation for future research on dd-cfDNA correlations with maternal fetal conditions to help improve allograft care for this specific patient population.