Novel DNA Analysis for Transplantation Patients

While organ transplants are one of medicine's most impressive life-saving achievements, the human body can attack the foreign organ, resulting in a 20–50% rejection rate within two years. Predicting organ rejection is difficult; yet long-term transplantation success is largely dependent on clinicians’ ability to prescribe the right balance of immunosuppressive drugs to keep the body from rejecting the organ, allowing it to live and do its job.

The Inspiration Behind the Innovation

Up until now, there has been no optimal marker to predict the probability of organ rejection in transplant patients. Current invasive procedures, such as organ tissue sampling (biopsy), often give a vague and imprecise indication of organ health – and only when the organ has severely deteriorated. A 2011 clinical study prompted the team to realise the potential of cell-free DNA (cfDNA) to inform decisions regarding immunosuppressive drugs. The study used cfDNA analysis to predict organ rejection several months before it happened. This showed that cfDNA measurements could guide treatment, reducing the risk of organ rejection while prolonging survival. Several more recent studies have also produced positive data regarding the use of cfDNA as a non-invasive marker of organ health.

The Innovation 

This solution identifies differing DNA targets between transplanted organs and their recipients. It then measures the organ-derived cfDNA against the patient’s own cfDNA – with fraction as the output. The team will try to identify fraction cutoffs for each organ type, indicating elevated organ damage. They will also describe the correlation between high cfDNA and organ rejection for all organ types. This direct measurement of organ damage using organ-derived cfDNA levels will hopefully avoid invasive procedures and may predict organ rejection much earlier and with substantially higher precision than other known markers, thereby providing clinicians the opportunity to optimise immunosuppressive therapy to prolong organ – and ultimately, patient survival.

The Team

Frederik Banch Clausen: Senior Research Scientist, Rigshospitalet

Grethe Risum Krog: Biomedical Laboratory Scientist, Rigshospitalet

Birgitte Bundgaard: Lead Technician, Rigshospitalet

Lasse W Wardil: Technician, Rigshospitalet

Kristine MCL Jørgensen: Technician, Rigshospitalet