{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T21:20:50Z","timestamp":1785360050167,"version":"3.55.0"},"reference-count":67,"publisher":"Akademiai Kiado Zrt.","issue":"33","license":[{"start":{"date-parts":[[2024,8,18]],"date-time":"2024-08-18T00:00:00Z","timestamp":1723939200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2024,8,18]]},"abstract":"<jats:p>A szolidszerv-transzplant\u00e1tum kil\u00f6k\u0151d\u00e9se a modern immunszuppressz\u00edv kezel\u00e9s\n                    mellett is a graftdiszfunkci\u00f3, a hospitaliz\u00e1ci\u00f3 \u00e9s a hal\u00e1loz\u00e1s egyik f\u0151\n                    etiol\u00f3giai t\u00e9nyez\u0151je. A rejekci\u00f3 diagnosztik\u00e1j\u00e1ban \u2019gold standard\u2019 invaz\u00edv\n                    biopszia azonban a hospitaliz\u00e1ci\u00f3 mellett sz\u00e1mos sz\u00f6v\u0151dm\u00e9nnyel j\u00e1rhat,\n                    interpret\u00e1l\u00e1s\u00e1t nagy interobszerver variabilit\u00e1s jellemzi. A rejekci\u00f3\n                    meg\u00edt\u00e9l\u00e9s\u00e9ben a noninvaz\u00edv m\u00f3dszerek ez\u00e9rt nagy klinikai jelent\u0151s\u00e9ggel b\u00edrnak. A\n                    graftk\u00e1rosod\u00e1st jellemz\u0151 donoreredet\u0171 sejtmentes DNS (dd-cfDNA) a recipiens\n                    sz\u00e9rum\u00e1b\u00f3l mutathat\u00f3 ki, szintje m\u00e1r a biopszia \u00e1ltal igazolt kil\u00f6k\u0151d\u00e9st\n                    megel\u0151z\u0151en emelked\u00e9st mutat, \u00e9s magas negat\u00edv predikt\u00edv \u00e9rt\u00e9kkel b\u00edr. Munk\u00e1nk\n                    sor\u00e1n a dd-cfDNA-assay szolid szerv (vese, m\u00e1j, sz\u00edv, t\u00fcd\u0151, hasny\u00e1lmirigy)\n                    transzplant\u00e1ci\u00f3j\u00e1t k\u00f6vet\u0151en bet\u00f6lt\u00f6tt szerep\u00e9t vizsg\u00e1ltuk az el\u00e9rhet\u0151 irodalom\n                    \u00f6sszefoglal\u00e1s\u00e1val, tov\u00e1bb\u00e1 a sz\u00edvtranszplant\u00e1ltak k\u00f6r\u00e9ben a rutin klinikai\n                    gyakorlatba 2022. okt\u00f3berben bevezetett dd-cfDNA-alap\u00fa rejekci\u00f3 ut\u00e1nk\u00f6vet\u00e9se\n                    sor\u00e1n nyert els\u0151 hazai eredm\u00e9nyeinket k\u00edv\u00e1njuk megosztani. Cardialis\n                    allograftrejekci\u00f3 ut\u00e1nk\u00f6vet\u00e9se sor\u00e1n 46 sz\u00edvtranszplant\u00e1lt beteg 264\n                    dd-cfDNA-mint\u00e1j\u00e1t elemezt\u00fck. Az eredm\u00e9ny a kering\u0151 donoreredet\u0171 sejtmentes DNS\n                    \u00e9s a plazma teljes (recipiens- \u00e9s donoreredet\u0171) sejtmentes DNS ar\u00e1ny\u00e1t mutatja:\n                    a \u22650,20% dd-cfDNA-\u00e9rt\u00e9k k\u00e1rosod\u00e1sra, m\u00edg a \u22650,35% dd-cfDNA-szint s\u00falyos\n                    graftk\u00e1rosod\u00e1sra utal. A dd-cfDNA-mint\u00e1k 80%-a &lt;0,20% \u00e9rt\u00e9ket mutatott.\n                    Myocardium-k\u00e1rosod\u00e1sra utal\u00f3 dd-cfDNA-\u00e9rt\u00e9k k\u00f6vetkezt\u00e9ben \u00f6sszesen 20\n                    sz\u00edvizom-biopszi\u00e1t v\u00e9gezt\u00fcnk: kil\u00f6k\u0151d\u00e9s 6 esetben igazol\u00f3dott. 16 h\u00f3nap sor\u00e1n\n                    232, a regul\u00e1ris surveillance-biopszi\u00e1k 88%-a biztons\u00e1gosan elhagyhat\u00f3 volt a\n                    dd-cfDNA-\u00e9rt\u00e9kek alapj\u00e1n. A korai graftk\u00e1rosod\u00e1s kimutat\u00e1sa \u00e1ltal lehet\u0151s\u00e9g\n                    ny\u00edlik az immunszuppressz\u00edv ter\u00e1pia korai \u00e9s szem\u00e9lyre szabott m\u00f3dos\u00edt\u00e1s\u00e1ra a\n                    s\u00falyosabb fok\u00fa kil\u00f6k\u0151d\u00e9s \u00e9s az irreverzibilis graftk\u00e1rosod\u00e1s megel\u0151z\u00e9se, illetve\n                    a gy\u00f3gyszertoxicit\u00e1s elker\u00fcl\u00e9se \u00e9rdek\u00e9ben. Orv Hetil. 2024; 165(33):\n                    1275\u20131285.<\/jats:p>","DOI":"10.1556\/650.2024.33106","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T11:31:22Z","timestamp":1724067082000},"page":"1275-1285","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":1,"title":["Noninvaz\u00edv rejekci\u00f3 ut\u00e1nk\u00f6vet\u00e9se szolid szervek \u00e1t\u00fcltet\u00e9s\u00e9t k\u00f6vet\u0151en: a donoreredet\u0171 sejtmentes DNS vizsg\u00e1lata"],"prefix":"10.1556","volume":"165","author":[{"given":"T\u00edmea","family":"Tesz\u00e1k","sequence":"first","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, V\u00e1rosmajori Sz\u00edv- \u00e9s \u00c9rgy\u00f3gy\u00e1szati Klinika Budapest, V\u00e1rosmajor u. 68., 1122 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csaba","family":"B\u00f6d\u00f6r","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Patol\u00f3giai \u00e9s K\u00eds\u00e9rleti R\u00e1kkutat\u00f3 Int\u00e9zet Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lajos","family":"Hegyi","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Patol\u00f3giai \u00e9s K\u00eds\u00e9rleti R\u00e1kkutat\u00f3 Int\u00e9zet Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"L\u00e9vay","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Patol\u00f3giai \u00e9s K\u00eds\u00e9rleti R\u00e1kkutat\u00f3 Int\u00e9zet Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Be\u00e1ta","family":"Nagy","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Patol\u00f3giai \u00e9s K\u00eds\u00e9rleti R\u00e1kkutat\u00f3 Int\u00e9zet Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila","family":"Fintha","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Patol\u00f3giai \u00e9s K\u00eds\u00e9rleti R\u00e1kkutat\u00f3 Int\u00e9zet Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9la","family":"Merkely","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, V\u00e1rosmajori Sz\u00edv- \u00e9s \u00c9rgy\u00f3gy\u00e1szati Klinika Budapest, V\u00e1rosmajor u. 68., 1122 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bal\u00e1zs","family":"Sax","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, V\u00e1rosmajori Sz\u00edv- \u00e9s \u00c9rgy\u00f3gy\u00e1szati Klinika Budapest, V\u00e1rosmajor u. 68., 1122 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Hart A, Lentine KL, Smith JM, et al. 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