{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T17:55:13Z","timestamp":1785779713626,"version":"3.56.0"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Donor derived cell\u2010free DNA (dd\u2010cfDNA) has become a useful biomarker for monitoring of kidney transplant rejection, however utilization after rejection is not well established. We conducted a retrospective cohort study of 64 kidney transplant recipients (KTRs) with biopsy\u2010proven rejection and concomitant dd\u2010cfDNA monitoring. The primary outcome was to examine the relationship between changes in dd\u2010cfDNA and allograft function after rejection. Secondary outcomes included the effect of a \u226561% dd\u2010cfDNA reduction on eGFR and proteinuria, and impact of persistently elevated dd\u2010cfDNA. The percent change in dd\u2010cfDNA from rejection to 6 months post\u2010rejection and 1\u2010year post\u2010rejection was negatively correlated with eGFR change at 1, 2, and 3 years. No correlation was seen with dd\u2010cfDNA values at 1 month. KTRs with at least 61% decrease in dd\u2010cfDNA from rejection to 1\u2010year post\u2010rejection showed improvement in eGFR at 1, 2, and 3 years. KTRs with persistently elevated dd\u2010cfDNA showed significantly worse change in eGFR to all time points compared to those without. Incidence of proteinuria at 1, 2, and 3 years trended lower in KTRs with \u226561% decrease in dd\u2010cfDNA. dd\u2010cfDNA was negatively correlated with eGFR, primarily at 6\u201312 months post\u2010rejection. In conclusion, persistently elevated dd\u2010cfDNA correlates with worse longitudinal changes in eGFR through 3 years post\u2010rejection.<\/jats:p>","DOI":"10.1111\/ctr.70603","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:29:49Z","timestamp":1782275389000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reduction in Donor\u2010Derived Cell\u2010Free DNA After Rejection Treatment is Associated With Improved Long Term Allograft Function"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0526-2865","authenticated-orcid":false,"given":"Lauren","family":"Schumacher","sequence":"first","affiliation":[{"name":"Department of Pharmacy University of Kentucky Healthcare  Lexington Kentucky 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