{"doi":"10.1111/petr.14708","title":"Evaluating threshold for donor fraction cell‐free <scp>DNA</scp> using clinically available assay for rejection in pediatric and adult heart transplantation","abstract":"BACKGROUND: The aims of the study were to assess the performance of a clinically available cell-free DNA (cfDNA) assay in a large cohort of pediatric and adult heart transplant recipients and to evaluate performance at specific cut points in detection of rejection. METHODS: Observational, non-interventional, prospective study enrolled pediatric and adult heart transplant recipients from seven centers. Biopsy-associated plasma samples were used for cfDNA measurements. Pre-determined cut points were tested for analytic performance. RESULTS: A total of 487 samples from 160 subjects were used for the analysis. There were significant differences for df-cfDNA values between rejection [0.21% (IQR 0.12-0.69)] and healthy samples [0.05% (IQR 0.01-0.14), p < .0001]. The pediatric rejection group had a median df-cfDNA value of 0.93% (IQR 0.28-2.84) compared to 0.09% (IQR 0.04-0.23) for healthy samples, p = .005. Overall negative predictive value was 0.94 while it was 0.99 for pediatric patients. Cut points of 0.13% and 0.15% were tested for various types of rejection profiles and were appropriate to rule out rejection. CONCLUSION: The study suggests that pediatric patients with rejection show higher levels of circulating df-cfDNA compared to adults and supports the specific cut points for clinical use in pediatric and adult patients with overall acceptable performance.","journal":"Pediatric Transplantation","year":2024,"id":453502,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.956,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":410913,"name":"Steven Zangwill","orcid":"0000-0002-1838-4714","position":1,"is_corresponding":false},{"id":415607,"name":"Marc E. Richmond","orcid":"0000-0001-5491-8085","position":2,"is_corresponding":false},{"id":410914,"name":"Steven J. Kindel","orcid":"0000-0002-8731-6942","position":3,"is_corresponding":false},{"id":274221,"name":"Jacob N. Schroder","orcid":"0000-0001-5836-7284","position":4,"is_corresponding":false},{"id":785606,"name":"Nunzio Gaglianello","orcid":"0000-0002-3866-6145","position":5,"is_corresponding":false},{"id":525462,"name":"David P. Bichell","orcid":"0000-0003-0227-1771","position":6,"is_corresponding":false},{"id":624578,"name":"M. Wigger","orcid":null,"position":7,"is_corresponding":false},{"id":734828,"name":"Kenneth R. Knecht","orcid":"0000-0002-4228-4473","position":8,"is_corresponding":false},{"id":1276832,"name":"P.T. Thrush","orcid":null,"position":9,"is_corresponding":false},{"id":469366,"name":"William T. Mahle","orcid":"0000-0003-1065-3972","position":10,"is_corresponding":false},{"id":410911,"name":"Paula E. North","orcid":"0000-0002-3996-1277","position":11,"is_corresponding":false},{"id":368741,"name":"Pippa Simpson","orcid":"0000-0003-1458-3748","position":12,"is_corresponding":false},{"id":449381,"name":"Liyun Zhang","orcid":"0000-0001-5882-2179","position":13,"is_corresponding":false},{"id":410910,"name":"Mahua Dasgupta","orcid":"0000-0002-5527-5250","position":14,"is_corresponding":false},{"id":410912,"name":"Aoy Tomita‐Mitchell","orcid":"0000-0002-7746-7528","position":15,"is_corresponding":false},{"id":410915,"name":"Michael E. Mitchell","orcid":"0000-0003-1605-6095","position":16,"is_corresponding":false},{"id":785605,"name":"Shriprasad R. Deshpande","orcid":"0000-0002-8358-9783","position":0,"is_corresponding":true}],"reference_count":23,"raw_metadata":null,"created_at":"2026-07-19T02:03:03.428151Z","pmid":"38553812","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}