Unmet need in Lung Transplant

59% Icon
Lung transplant recipients experience the lowest median survival (6.7 years) of any solid organ transplants, with a 5-year survival of 59%¹.
CLAD Icon
Lung transplant recipients have an increased incidence of chronic organ rejection, termed “Chronic Lung Allograft Dysfunction” (CLAD).
Lung Infection Icon
There is an increased frequency of respiratory infectious complications due both to the intimate contact of the lung graft and outside environment, and more intensive immunosuppressive regimens to forestall rejection.
Block Icon
There are no clinically available biomarkers for noninvasive detection of graft rejection, infection or CLAD; therefore, diagnosis has usually been dependent on invasive bronchoscopy and biopsy procedures.

What is AlloSure Lung?

  • AlloSure is a donor-derived cell-free DNA (dd-cfDNA) test for noninvasive transplant surveillance, providing a direct measure of organ injury, that has been successfully validated and is now reimbursed for both kidney and heart transplant recipients.
  • AlloSure Lung represents a noninvasive and desperately needed solution for the surveillance of lung transplant recipients.

How Does AlloSure Lung Work?

Cell-free DNA is fragmented DNA originating from cells and continuously released into the bloodstream


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


AlloSure can quantify increasing levels of dd-cfDNA, serving as a leading indicator of graft injury

What is the Clinical Evidence Supporting AlloSure Lung?

AlloSure Lung was clinically validated in a multi-center prospective study – the Lung Allograft Rejection Gene Expression Observational (LARGO) study2– which included 9 transplant centers and 69 patients:

This study found that AlloSure scores were significantly elevated in the presence of acute cellular rejection (ACR).
These findings were further supported by a single center study at Stanford, which observed an elevation in AlloSure scores in the event of ACR, antibody-mediated rejection (AMR), and CLAD3:

The results of both the LARGO and Stanford studies show that the dd-cfDNA levels were significantly elevated in both ACR and obstructive phenotype CLAD. The levels of dd-cfDNA in the case of AMR were also elevated, although they did not achieve statistical significance (likely due to sample size).


Additionally, a pivotal multi-center collaboration with National Institute of Health (NIH), CareDx, Inc. and lung transplant centers at Johns-Hopkins University, University of Maryland, Inova Medical Center and University of Texas, San Antonio – the Analysis of Lung Allograft Remote Monitoring (ALARM-1) Study, has recently completed with publication in press.

AlloSure Surveillance Provides Actionable Information for Patient Management

AlloSure Lung provides peace of mind that injury is unlikely with dd-cfDNA levels below 0.5%.


AlloSure Lung can help guide physicians whether bronchoscopy with lavage and biopsies may be necessary when dd-cfDNA levels are elevated.

Future Availability

  • While AlloSure Lung is not currently commercially available, it is undergoing rigorous review by the Centers for Medicare & Medicaid Services (CMS) MolDx program to obtain coverage for lung transplant patients.
  • AlloSure Lung can currently be obtained on a compassionate use basis; for more information please reach out to info@caredx.com.