{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:27:12Z","timestamp":1782311232386,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100020295","name":"Natera","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020295","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The gold standard approach to the diagnosis of rejection in kidney transplant recipients currently relies on tissue obtained during biopsies. However, repeat performance of biopsies is cumbersome, and use of dd\u2010cfDNA in conjunction with eGFR may help inform whether ongoing rejection may be persistent after a diagnosis of rejection is made by biopsy and anti\u2010rejection treatment administered. In this single\u2010center prospective study, 52 patients with rejection were followed longitudinally over time with quarterly dd\u2010cfDNA measurements, of whom 78% had repeat biopsies to confirm the presence or absence of persistent rejection. With every 1 percentage point higher baseline (\u201cfirst\u201d) dd\u2010cfDNA levels drawn at time of enrollment, the odds of persistent rejection were 1.35 (95% CI 1.18\u20101.55) higher. With every 1 percentage point increase in the slope of dd\u2010cfDNA levels over time, the odds of persistent rejection were 1.62 times higher (95% CI 1.10\u20102.38). Models including only baseline and the slope of dd\u2010cfDNA provided moderate risk discrimination for rejection (c = 0.73), which improved to c = 0.75 with the addition of eGFR at baseline and change in eGFR over time. Monitoring of dd\u2010cfDNA may offer reasonable discrimination of the likelihood of persistent rejection following anti\u2010rejection therapy. Further validation of these findings is needed.<\/jats:p>","DOI":"10.1111\/ctr.70443","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:33:36Z","timestamp":1768566816000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Donor\u2010Derived Cell\u2010Free DNA Levels and Prediction of Resolution of Rejection in Kidney Transplant Recipients"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7774-2526","authenticated-orcid":false,"given":"Elaine","family":"Ku","sequence":"first","affiliation":[{"name":"Department of Medicine University of California San Francisco  San Francisco California USA"},{"name":"Department of Pediatrics University of California San Francisco  San Francisco California USA"},{"name":"Department of Epidemiology and Biostatistics University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Winnicki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Legaspi","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles E.","family":"McCulloch","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Adey","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2016091034"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2023.11899"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.11.034"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.12945"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.11991019"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14320"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0000000000005007"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2021091191"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8010019"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2025.07.009"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2009.02834.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.34067\/kid.0000042021"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14258"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.70019"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14617"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2025.07.2470"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16150"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010024\u201003087\u20103"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70443","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.70443","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70443","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T11:09:56Z","timestamp":1776251396000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.70443"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ctr.70443"],"URL":"https:\/\/doi.org\/10.1111\/ctr.70443","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-09-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70443"}}