{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:08:44Z","timestamp":1791929324078,"version":"4.3.4"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["AGBORE20QI0"],"award-info":[{"award-number":["AGBORE20QI0"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Distinguished Scholar Program"},{"name":"National Heart, Lung, and Blood Institute, Division of Intramural Research"},{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["AGBORE20QI0"],"award-info":[{"award-number":["AGBORE20QI0"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000897","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Distinguished Scholar Program"},{"DOI":"10.13039\/100000897","name":"National Heart, Lung, and Blood Institute, Division of Intramural Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Plasma cell-free DNA levels correlate with disease severity in many conditions. Pretransplant cell-free DNA may risk stratify lung transplant candidates for post-transplant complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate if pretransplant cell-free DNA levels and tissue sources identify patients at high risk of primary graft dysfunction and other pre- and post-transplant outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter, prospective cohort study recruited 186 lung transplant candidates. Pretransplant plasma samples were collected to measure cell-free DNA. Bisulfite sequencing was performed to identify the tissue sources of cell-free DNA. Multivariable regression models determined the association between cell-free DNA levels and the primary outcome of primary graft dysfunction and other transplant outcomes, including Lung Allocation Score, chronic lung allograft dysfunction, and death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Transplant candidates had twofold greater cell-free DNA levels than healthy control patients (median [interquartile range], 23.7\u2009ng\/ml [15.1\u201335.6] vs. 12.9\u2009ng\/ml [9.9\u201318.4]; P\u2009&amp;lt;\u20090.0001), primarily originating from inflammatory innate immune cells. Cell-free DNA levels and tissue sources differed by native lung disease category and correlated with the Lung Allocation Score (P\u2009&amp;lt;\u20090.001). High pretransplant cell-free DNA increased the risk of primary graft dysfunction (odds ratio, 1.60; 95% confidence interval [CI], 1.09\u20132.46; P\u2009=\u20090.0220), and death (hazard ratio, 1.43; 95% CI, 1.07\u20131.92; P\u2009 =\u20090.0171) but not chronic lung allograft dysfunction (hazard ratio, 1.37; 95% CI, 0.97\u20131.94; P\u2009 =\u20090.0767).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lung transplant candidates demonstrate a heightened degree of tissue injury with elevated cell-free DNA, primarily originating from innate immune cells. Pretransplant plasma cell-free DNA levels predict post-transplant complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202306-1064oc","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T10:19:40Z","timestamp":1703067580000},"page":"727-737","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":14,"title":["Cell-Free DNA Maps Tissue Injury and Correlates with Disease Severity in Lung Transplant Candidates"],"prefix":"10.1093","volume":"209","author":[{"given":"Shanti","family":"Balasubramanian","sequence":"first","affiliation":[{"name":"Genomic Research Alliance for Transplantation, Bethesda, Maryland"},{"name":"Division of Intramural Research, Laboratory of Applied Precision Omics, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland"},{"name":"Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Richert","sequence":"additional","affiliation":[{"name":"Genomic Research Alliance for Transplantation, Bethesda, Maryland"},{"name":"Division of Intramural Research, Laboratory of Applied Precision Omics, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland"},{"name":"Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyesik","family":"Kong","sequence":"additional","affiliation":[{"name":"Genomic Research Alliance for Transplantation, Bethesda, Maryland"},{"name":"Division of Intramural Research, Laboratory of Applied Precision Omics, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng","family":"Fu","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moon Kyoo","family":"Jang","sequence":"additional","affiliation":[{"name":"Genomic Research Alliance for Transplantation, Bethesda, Maryland"},{"name":"Division of Intramural Research, Laboratory of Applied Precision Omics, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Temesgen E.","family":"Andargie","sequence":"additional","affiliation":[{"name":"Genomic Research Alliance for Transplantation, Bethesda, Maryland"},{"name":"Division of Intramural Research, Laboratory of Applied Precision Omics, National Heart, Lung, and Blood Institute, National 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Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shambhu","family":"Aryal","sequence":"additional","affiliation":[{"name":"Genomic Research Alliance for Transplantation, Bethesda, Maryland"},{"name":"Advanced Lung Disease and Lung Transplant Program, Inova Fairfax Hospital, Fairfax, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Errol L.","family":"Bush","sequence":"additional","affiliation":[{"name":"Genomic Research Alliance for Transplantation, Bethesda, Maryland"},{"name":"Department of Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Cantu","sequence":"additional","affiliation":[{"name":"Genomic Research Alliance for Transplantation, Bethesda, Maryland"},{"name":"Department of Surgery, University of Pennsylvania, Philadelphia, 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