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Graft-Derived Cell-Free DNA as a Biomarker in Liver Transplantation

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Biomarkers in Liver Disease

Abstract

Improvement of long-term patient and graft outcome is still a challenge in liver transplantation. Personalized approaches to immunosuppressive treatment of liver transplant patients are currently under investigation, as conventional markers have limited usefulness to predict drug efficacy. The presence of graft-derived cell-free DNA (GcfDNA) in the plasma of liver transplant recipients opens up the possibility of monitoring allograft injury through measurement of this molecular marker. A rapid, cost-effective droplet digital PCR (ddPCR) method has been developed for the quantification of donor DNA. GcfDNA has shown to be useful for the detection of subclinical and full-blown acute rejection and non-rejection-related liver injury (e.g., HCV infection, liver trauma, ischemia/reperfusion damage). GcfDNA allows for the early detection of transplant injury (“liquid biopsy”) and enables earlier more effective treatment intervention. It is especially helpful to guide changes in immunosuppression and to monitor immunosuppression minimization. This new approach may contribute to achieve more effective, less toxic personalized immunosuppression.

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Abbreviations

AST:

Aspartate aminotransferase

cfDNA:

Cell-free DNA

ddPCR:

Droplet digital PCR

DNA:

Deoxyribonucleic acid

GcfDNA:

Graft-derived cell-free DNA

HCV:

Hepatitis C virus

HELLP:

Hemolysis, elevated liver enzymes, low platelets

ISD:

Immunosuppressive drug

LFTs:

Liver function tests

LTx:

Liver transplantation

PCR:

Polymerase chain reaction

TDM:

Therapeutic drug monitoring

WBC:

White blood cells

γ-GT:

γ-glutamyltransferase

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Authors and Affiliations

  1. Department of Clinical Pharmacology, University Medical Center Göttingen, Kreuzbergring 36, 37075, Göttingen, Germany

    Michael Oellerich & Philip D. Walson

  2. Chronix Biomedical GmbH, Goetheallee 8, 37073, Göttingen, Germany

    Ekkehard Schütz & Julia Beck

  3. Helios Dr. Horst Schmidt Kliniken Wiesbaden, Horst-Erhard-Str. 100, 65199, Wiesbaden, Germany

    Otto Kollmar

  4. Department of Clinical Pharmacology, University Medical Center Göttingen, Kreuzbergring 36, 37075, Göttingen, Germany

    Philipp Kanzow & Anna Blum

  5. Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany

    Philipp Kanzow

Authors
  1. Michael Oellerich
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  2. Ekkehard Schütz
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  3. Julia Beck
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  4. Otto Kollmar
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  5. Philipp Kanzow
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  6. Anna Blum
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  7. Philip D. Walson
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Corresponding author

Correspondence to Michael Oellerich .

Editor information

Editors and Affiliations

  1. Sciences Division, King's College, London, United Kingdom

    Victor R. Preedy

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© 2015 Springer Science+Business Media Dordrecht

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Oellerich, M. et al. (2015). Graft-Derived Cell-Free DNA as a Biomarker in Liver Transplantation. In: Preedy, V. (eds) Biomarkers in Liver Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7742-2_10-1

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  • DOI: https://doi.org/10.1007/978-94-007-7742-2_10-1

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  • Publisher Name: Springer, Dordrecht

  • Online ISBN: 978-94-007-7742-2

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