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What is cfDNA?

Cell-free DNA: A Clear Biomarker for Organ Injury

Cell-free (cfDNA) is fragmented DNA in the bloodstream that originates from cells undergoing cell injury and death.


AlloSeq cfDNA measures cfDNA, and uses single nucleotide polymorphisms (SNPs) to distinguish between donor and recipient.


dd-cfDNA is a powerful, minimally invasive tool for organ transplant surveillance.

How is dd-cfDNA Used?

Allograft Surveillance with dd-cfDNA Testing: Assessment of Injury Risk


AlloSeq cfDNA - Assessment of Injury Risk

How is it Used in Action to Protocols with Ease?


AlloSeq cdDNA - How it is used

What is AlloSeq cfDNA?

AlloSeq cfDNA is a minimally invasive blood test that measures the amount of donor-derived cell-free DNA (dd-cfDNA) for transplant surveillance. It is currently only available outside of the United States.

AlloSeq cfDNA Kit

  • NGS based test to run in your own lab and does not require prior genotyping
  • Targets 202 bi-allelic SNPs across 22 autosomes
  • Test up to 24 samples/run that is validated on Illumina MiniSeq and MiSeq
  • Analytically validated by multi-centric study
  • From cfDNA sample to reported result < 24 hrs with < 1.5 hrs hands-on time
  • Allows reporting dd-cfDNA as fraction
  • Ability to calculate absolute copies and monitor more than one donor cfDNA contributor

AlloSeq cfDNA Service (Currently available in Europe)

  • Alternate way to send your samples into the CareDx lab to validate or use AlloSeq cfDNA without needing NGS equipment
  • Simple sample collection process with an easy-to-interpret report delivered directly to you
  • More information can be found here

AlloSeq cfDNA is Based on the Clinically Validated AlloSure** Across Multiple Solid Organs with Data-driven Insights from Multi-center Studies

  • AlloSure is the dd-cfDNA surveillance service that has been clinically and analytically validated for identifying kidney, heart and lung injury.
  • AlloSure is the most published dd-cfDNA test in transplantation with over 100+ peer reviewed journal publications.

Interpretation of dd-cfDNA Results in Kidney, Heart and Lung Transplantation

At varying levels provides meaningful, actionable information to your existing clinical setting.

Cut-off values suggested are clinically validated by CareDx with service modality AlloSure for assessing the risk of allograft rejection.

Want to Order AlloSeq cfDNA Surveillance Tests?

AlloSeq cfDNA Service: Send in samples to CareDx central lab in Stockholm, Sweden, Email: servicetesting@caredx.com or call +46-8-50893900

AlloSeq cfDNA Kit: To learn more about how to bring AlloSeq cfDNA to your own lab, contact your CareDx representative or reach out to us:

Americas: orders-US@caredx.com

EMEA: orders-se@caredx.com

APAC: orders-aus@caredx.com

Ordering Information

Product No. RXNs Product Code
AlloSeq cfDNA – IVD 24 ASCF.1(24)-IVD
AlloSeq cfDNA – RUO 24 ASCF.1(24)
AlloSeq cfDNA Software N/A ASCFS1.0
AlloSeq cfDNA Service- RUO only N/A N/A
Product No. RXNs Product Code
AlloSeq cfDNA – IVD 24 ASCF.1(24)-IVD
AlloSeq cfDNA – RUO 24 ASCF.1(24)
AlloSeq cfDNA Software N/A ASCFS1.0
AlloSeq cfDNA Service- RUO only N/A N/A

Multi-Organ Transplant Publications

Publication First Author Journal Year
Kidney
Normalization dynamics of donor-derived cell-free DNA predicts future kidney transplant rejection Cucchiari D Nephrology Dialysis Transplantation In press
Implementation of the in-house technique for the determination of donor-derived cell-free DNA in daily clinical practice: experience from the Hospital Clinic of Barcelona Read original article in Spanish Cuadrado-Payán E Nefrología In press
Evaluation of a decentralized donor-derived cell-free DNA assay for kidney allograft rejection monitoring Read more Loupy A Transplant International 2024
Multi-centre analytical performance verification of an IVD assay to quantify donor-derived cell-free DNA in solid organ transplant recipients Read more Casas S HLA 2024
Donor-derived cell-free DNA predicted allograft rejection and severe microvascular inflammation in kidney transplant recipients Read more Kim HD Frontiers in Immunology 2024
Donor-derived cell-free DNA (dd-cfDNA) in kidney transplant recipients with indication biopsy-results of a prospective single-center trial
Read more
Benning L Transplant International 2023
Cell-free DNA measurement of three genomes after allogeneic MSC therapy in kidney transplant recipients indicates early cell death of infused MSC Read more Dreyer GJ Frontiers in Immunology 2023
Assessment of donor derived cell-free DNA (dd-cfDNA) at surveillance and at clinical suspicion of acute rejection in renal transplantation
Read more
Mantios E Transplant International 2023
Donor-derived cell-free DNA at 1 month after kidney transplantation relates to HLA Class II Eplet mismatch load Read more González-López E Biomedicines 2023
Early kinetics of donor-derived cell-free DNA after transplantation predicts renal graft recovery and long-term function Read more Cucchiari D Nephrology Dialysis Transplantation 2023
Immune response to COVID-19 mRNA vaccination in previous nonresponder kidney transplant recipients after short-term withdrawal of mycophenolic acid 1 and 3 months after an additional vaccine dose
Read more
Kühn T Transplantation 2023
Humoral response to SARS-CoV-2 mRNA vaccination in previous non-responder kidney transplant recipients after short-term withdrawal of mycophenolic acid Read more Benning L Frontiers in Medicine 2022
Levels of donor-derived cell-free DNA and chemokines in BK polyomavirus-associated nephropathy
Read more
Mayer AK Clinical Transplantation 2022
Anti-interleukin-6 Antibody Clazakizumab in Antibody-mediated Kidney Transplant Rejection: Effect on Donor-derived Cell-free DNA and C-X-C Motif Chemokine Ligand 10 Read more Mayer AK Transplant Direct 2022
A comparison of two different analytical methods for donor-derived cell-free DNA quantification
Read more
Verhoeven JGHP Clinical Biochemistry 2021
Diagnostic value of donor-derived cell-free DNA to predict antibody-mediated rejection in donor-specific antibody-positive renal allograft recipients Read more Mayer AK Transplant International 2021
Liver
Monitoring of donor-derived cell-free DNA by short tandem repeats: Concentration of total cell-free DNA and fragment size for acute rejection risk assessment in liver transplantation Read more Fernández-Galán E Liver Transplantation 2022
Kidney, Liver
Comparison of methods for donor-derived cell-free DNA quantification in plasma and urine from solid organ transplant recipients Read more Kueng N Frontiers in Genetics 2023
Lung
Donor-derived cell-free DNA in chronic lung allograft dysfunction phenotypes: a pilot study Read more Beeckmans H Frontiers in Transplantation 2024
Clinical relevance of cell-free DNA quantification and qualification during the first month after lung transplantation Read more Pedini P Frontiers in Immunology 2023
Heart
Noninvasive rejection surveillance after solid organ transplantations: analysis of the donor-derived cell-free DNA Read original article in Hungarian Teszák T Orvosi Hetilap 2024
Local laboratory-run donor-derived cell-free DNA assay for rejection surveillance in heart transplantation – First six months of clinical experience Read more Teszák T Clinical Transplantation 2023
Publication First Author Journal Year
Kidney
Normalization dynamics of donor-derived cell-free DNA predicts future kidney transplant rejection Cucchiari D Nephrology Dialysis Transplantation In press
Implementation of the in-house technique for the determination of donor-derived cell-free DNA in daily clinical practice: experience from the Hospital Clinic of Barcelona Read original article in Spanish Cuadrado-Payán E Nefrología In press
Evaluation of a decentralized donor-derived cell-free DNA assay for kidney allograft rejection monitoring Read more Loupy A Transplant International 2024
Multi-centre analytical performance verification of an IVD assay to quantify donor-derived cell-free DNA in solid organ transplant recipients Read more Casas S HLA 2024
Donor-derived cell-free DNA predicted allograft rejection and severe microvascular inflammation in kidney transplant recipients Read more Kim HD Frontiers in Immunology 2024
Donor-derived cell-free DNA (dd-cfDNA) in kidney transplant recipients with indication biopsy-results of a prospective single-center trial
Read more
Benning L Transplant International 2023
Cell-free DNA measurement of three genomes after allogeneic MSC therapy in kidney transplant recipients indicates early cell death of infused MSC Read more Dreyer GJ Frontiers in Immunology 2023
Assessment of donor derived cell-free DNA (dd-cfDNA) at surveillance and at clinical suspicion of acute rejection in renal transplantation
Read more
Mantios E Transplant International 2023
Donor-derived cell-free DNA at 1 month after kidney transplantation relates to HLA Class II Eplet mismatch load Read more González-López E Biomedicines 2023
Early kinetics of donor-derived cell-free DNA after transplantation predicts renal graft recovery and long-term function Read more Cucchiari D Nephrology Dialysis Transplantation 2023
Immune response to COVID-19 mRNA vaccination in previous nonresponder kidney transplant recipients after short-term withdrawal of mycophenolic acid 1 and 3 months after an additional vaccine dose
Read more
Kühn T Transplantation 2023
Humoral response to SARS-CoV-2 mRNA vaccination in previous non-responder kidney transplant recipients after short-term withdrawal of mycophenolic acid Read more Benning L Frontiers in Medicine 2022
Levels of donor-derived cell-free DNA and chemokines in BK polyomavirus-associated nephropathy
Read more
Mayer AK Clinical Transplantation 2022
Anti-interleukin-6 Antibody Clazakizumab in Antibody-mediated Kidney Transplant Rejection: Effect on Donor-derived Cell-free DNA and C-X-C Motif Chemokine Ligand 10 Read more Mayer AK Transplant Direct 2022
A comparison of two different analytical methods for donor-derived cell-free DNA quantification
Read more
Verhoeven JGHP Clinical Biochemistry 2021
Diagnostic value of donor-derived cell-free DNA to predict antibody-mediated rejection in donor-specific antibody-positive renal allograft recipients Read more Mayer AK Transplant International 2021
Liver
Monitoring of donor-derived cell-free DNA by short tandem repeats: Concentration of total cell-free DNA and fragment size for acute rejection risk assessment in liver transplantation Read more Fernández-Galán E Liver Transplantation 2022
Kidney, Liver
Comparison of methods for donor-derived cell-free DNA quantification in plasma and urine from solid organ transplant recipients Read more Kueng N Frontiers in Genetics 2023
Lung
Donor-derived cell-free DNA in chronic lung allograft dysfunction phenotypes: a pilot study Read more Beeckmans H Frontiers in Transplantation 2024
Clinical relevance of cell-free DNA quantification and qualification during the first month after lung transplantation Read more Pedini P Frontiers in Immunology 2023
Heart
Noninvasive rejection surveillance after solid organ transplantations: analysis of the donor-derived cell-free DNA Read original article in Hungarian Teszák T Orvosi Hetilap 2024
Local laboratory-run donor-derived cell-free DNA assay for rejection surveillance in heart transplantation – First six months of clinical experience Read more Teszák T Clinical Transplantation 2023

References

  • Bu L, et al. Clinical outcomes from the Assessing Donor-derived cell-free DNA Monitoring Insights of kidney Allografts with Longitudinal surveillance (ADMIRAL) study. Kidney Int. 2022 Apr;101(4):793-803.
  • Grskovic M, et al. Validation of a Clinical-Grade Assay to Measure Donor- Derived Cell-Free DNA in Solid Organ Transplant Recipients. J Mol Diagn. 2016 Nov;18(6):890-902.
  • Khush KK, et al. Noninvasive detection of graft injury after heart transplant using donor-derived cell-free DNA: A prospective multicenter study. Am J Transplant. 2019 Oct;19(10):2889-2899.2019 Oct;19(10):2889-2899.
  • Sayah D, et al. Plasma Donor-derived Cell-free DNA Levels Are Increased During Acute Cellular Rejection After Lung Transplant: Pilot Data. Transplant Direct. 2020 Sep 24;6(10):e608.
  • Khush KK, et al. Donor-derived, cell-free DNA levels by next-generation targeted sequencing are elevated in allograft rejection after lung transplantation. ERJ Open Res. 2021 Jan 25;7(1):00462-2020.
  • Bloom RD, et al. Circulating Donor-Derived Cell-Free DNA in Blood for Diagnosing Active Rejection in Kidney Transplant Recipients (DART) Study Investigators. Cell-Free DNA and Active Rejection in Kidney Allografts. J Am Soc Nephrol. 2017 Jul;28(7):2221-2232.
  • Evaluation of Patient Outcomes From the Kidney Allograft Outcomes AlloSure Registry (KOAR). ClinicalTrials.gov Identifier: NCT03326076
  • Pai A, et al. Clinical Rationale for a Routine Testing Schedule Using Donor- Derived Cell-Free DNA After Kidney Transplantation. Ann Transplant. 2021 Jul 2;26:e932249.
  • Pham MX, et al; IMAGE Study Group. Gene-expression profiling for rejection surveillance after cardiac transplantation. N Engl J Med. 2010 May 20;362(20):1890-900.
  • Surveillance HeartCare® Outcomes Registry (SHORE). ClinicalTrials.gov Identifier: NCT03695601
  • Keller M, et al. Donor-derived cell-free DNA as a composite marker of acute lung allograft dysfunction in clinical care. J Heart Lung Transplant. 2022 Apr;41(4):458-466.
  • AlloSure Lung Assessment and Metagenomics Outcomes Study (ALAMO). ClinicalTrials.gov Identifier: NCT05050955

*AlloSeq cfDNA and AlloSeq cfDNA Software is available as CE/IVD and Research Use only. AlloSeq cfDNA service testing in Stockholm, Sweden is ISO 17025 accredited. For local regulatory status, please contact CareDx. AlloSeq cfDNA is only available outside of the United States. AlloSeq is a trademark or registered trademark of CareDx, Inc. or its subsidiaries in the US or other countries. AlloSeq is a registered trademark with the US Patent and Trademark Office. Research Use Only products are not to be used for diagnostic procedures.

**AlloSure is available as a dd-cfDNA service within the US only.

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