Transplantation medicine, quantification of donor-derived cell-free DNA using whole genome next-generation sequencing, plasma, reported as percentage of donor-derived cell-free DNA in the total cell-free DNA
CPT4 code
Name of the Procedure:
Transplantation Medicine, Quantification of Donor-Derived Cell-Free DNA Using Whole Genome Next-Generation Sequencing, Plasma. Commonly referred to as Donor-Derived Cell-Free DNA (dd-cfDNA) Testing or Donor-Derived DNA Monitoring.
Summary
This procedure measures the amount of donor-derived cell-free DNA in a transplant recipient's blood. By analyzing blood plasma using advanced sequencing techniques, doctors can determine the percentage of DNA originating from the transplanted organ.
Purpose
This test is primarily used to monitor the health and function of a transplanted organ. It helps in detecting early signs of organ rejection by identifying an increased presence of donor-derived DNA in the recipient's bloodstream. The goal is to intervene early to prevent organ failure and improve transplant outcomes.
Indications
- Routine monitoring after organ transplantation (e.g., kidney, heart, liver).
- Suspected organ rejection.
- Unexplained changes in organ function.
- Immunosuppressant therapy adjustments.
Preparation
- No specific fasting is required.
- Inform your doctor about all medications and supplements.
- Blood sample collection may be scheduled along with other routine follow-up assessments.
Procedure Description
- A healthcare provider will draw a blood sample from the patient.
- The plasma is separated from the blood cells in the laboratory.
- Using whole genome next-generation sequencing (NGS), the plasma is analyzed to identify and quantify the proportion of donor-derived cell-free DNA.
Duration
The blood draw takes a few minutes, but the overall process, including laboratory analysis, may take several days to a week.
Setting
The blood sample is collected in a hospital or outpatient clinic and sent to a specialized laboratory for analysis.
Personnel
- Phlebotomist or nurse for blood collection.
- Lab technicians and specialists for NGS analysis.
- Transplant specialists and physicians will review and interpret the results.
Risks and Complications
- Minor discomfort or bruising at the blood draw site.
- Extremely rare risk of infection.
- Potential for misleading results due to technical or biological factors.
Benefits
- Early detection of organ rejection.
- Non-invasive compared to biopsy.
- Allows for timely intervention and personalized treatment adjustments.
- Can improve long-term transplant success and patient outcomes.
Recovery
- No recovery time needed for the blood draw.
- Follow your doctor’s instructions for any changes in medication or follow-up appointments based on test results.
Alternatives
- Biopsy of the transplanted organ (more invasive, carries higher risk).
- Other blood-based biomarkers (less specific or sensitive).
- Regular imaging or functional tests (may not detect early rejection).
Patient Experience
- The patient may feel a brief pinch during the blood draw.
- Minimal discomfort after the procedure.
- Awaiting results can cause anxiety, which can be mitigated by discussing concerns with healthcare providers. Pain management is generally not required.