Lung Transplant Recipients with Severe Primary Graft Dysfunction Requiring ECMO Had Similar Donor-Derived Cell-Free DNA Levels and Lung Function as Matched Controls

Lung Transplant Recipients with Severe Primary Graft Dysfunction Requiring ECMO Had Similar Donor-Derived Cell-Free DNA Levels and Lung Function as Matched Controls

Extracorporeal Membrane Oxygenation (ECMO) is a lifesaving procedure in lung transplant recipients with severe primary graft dysfunction (PGD). There is limited information regarding the impact of post-op ECMO on lung allograft function. Circulating donor-derived cell-free DNA (dd-cf-DNA) has emerge...

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Bibliographic Details
Published in:The Journal of heart and lung transplantation Vol. 39; no. 4; pp. S329 - S330
Main Authors: Timofte, I., Iacono, A., Terrin, M., Vesselinov, R., Bhatti, K., Marishta, A., Young, C., Pervaiz, A., Fideli, U., Tunc, I., Kwesiga, D.M., Orens, J., Shah, P., Nathan, S.D., Brown, A.W., Valantine, H.A., Agbor-Enoh, S.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-04-2020
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Summary:Extracorporeal Membrane Oxygenation (ECMO) is a lifesaving procedure in lung transplant recipients with severe primary graft dysfunction (PGD). There is limited information regarding the impact of post-op ECMO on lung allograft function. Circulating donor-derived cell-free DNA (dd-cf-DNA) has emerged as a potential biomarker of lung allograft injury. The goal of our study is to compare the dynamic dd-cf-DNA changes in patients that required ECMO support with changes in lung transplant patients that did not require ECMO. Peri-transplant (pre-transplant and days 1, 3, 7 and 10, 14, 30, 60, 90 post-transplantation) plasma samples from lung transplant recipients (LTRs)of the Genomic Research Alliance for Transplantation (GRAfT) were analyzed for dd-cf-dDNA by next generation sequencing. After matching for gender, type of transplant (single versus double), and underlying diagnosis, the dd-cf-DNA levels and 3 month post-transplant lung function was compared among patients who required (n=9) and did not require (n=45) ECMO post-operatively. The dd-cf-DNA levels were similar between patients with PGD that required ECMO compared to non ECMO patients. The dd-cf-DNA levels for both ECMO patients and their matched controls were decreased by day 10 (Figure 1). The figure illustrates dd-cf-DNA trends for 2 matched cases (ECMO) and 10 controls (not ECMO), showing high initial post-transplant dd-cf-DNA levels followed by an exponential decay. There was no difference between lung function (FEV1) at 3 months between the ECMO patients and their matched controls (p=0.27)-Figure 2. This report suggests that despite a higher risk for postoperative mortality, patients with severe primary graft failure requiring ECMO had similar cfDNA dynamics and lung function at 3-months post-transplant.
ISSN:1053-2498
1557-3117
DOI:10.1016/j.healun.2020.01.348