{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T20:07:59Z","timestamp":1786133279955,"version":"build-2736575974"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016477","name":"CareDx, Inc.","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100016477","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["JASN"],"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>We assessed whether an initial donor-derived cell-free DNA elevation during routine surveillance was associated with allograft dysfunction and loss in kidney transplant recipients.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Intermediate and high donor-derived cell-free DNA states were independently associated with 3.7-fold and 6.4-fold higher risks of allograft loss, respectively.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Persistently low donor-derived cell-free DNA levels were associated with low rates of rejection and allograft loss, identifying a low-risk population.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although donor-derived cell-free DNA (dd-cfDNA) correlates with histologic rejection and injury severity, its association with long-term graft outcomes has yet to be well established in kidney transplant recipients. We hypothesize that among patients monitored with dd-cfDNA, an initial elevation may be associated with subsequent allograft dysfunction and loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Kidney Allograft Outcomes AlloSure Registry is a prospective, multicenter cohort of 1743 adult kidney transplant recipients from 56 US centers; this analysis included 1258 patients who initiated dd-cfDNA surveillance 15\u201360 days post-transplant with up to 3-year follow-up. A multistate model was applied to characterize transitions from a low dd-cfDNA state (no elevations) to intermediate (0.5%\u20131.0% with \u226561% relative change value) or high (\u22651.0%) dd-cfDNA states, and their unadjusted and covariate-adjusted associations with allograft loss or all-cause death were quantified using hazard regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Within 3 years, 36% of patients transitioned to an elevated dd-cfDNA state (intermediate\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =216; high\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =233). Allograft dysfunction by 36 months occurred significantly more often in patients with dd-cfDNA elevations despite preserved allograft function at the time of elevation (eGFR \u226560 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      in 42% of intermediate and 33% of high), consistent with subclinical injury. Transitions from low to elevated dd-cfDNA states were strongly associated with subsequent allograft loss (adjusted hazard ratios, 3.70 [95% confidence interval [CI], 1.38 to 9.90] for intermediate; 6.36 [95% CI, 2.80 to 14.42] for high), while mortality did not differ by dd-cfDNA state.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Initial dd-cfDNA elevations exceeding established thresholds were independently associated with higher risks of allograft dysfunction and loss across both elevation categories, whereas patients who remained in the low dd-cfDNA state experienced favorable outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1681\/asn.0000001133","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:00:07Z","timestamp":1781632807000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Elevations in Donor-Derived Cell-Free DNA and Allograft Outcomes in Kidney Transplantation"],"prefix":"10.1681","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4529-4376","authenticated-orcid":false,"given":"Jeffrey A.","family":"Klein","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas, Kansas City, Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7273-4589","authenticated-orcid":false,"given":"David","family":"Taber","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9170-9338","authenticated-orcid":false,"given":"David","family":"Wojciechowski","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3326-8583","authenticated-orcid":false,"given":"Didier A.","family":"Mandelbrot","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Wisconsin Hospital, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9521-7373","authenticated-orcid":false,"given":"Renata","family":"Glehn-Ponsirenas","sequence":"additional","affiliation":[{"name":"CareDx, Inc, Brisbane, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5911-135X","authenticated-orcid":false,"given":"Oyedolamu","family":"Olaitan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Rush University Medical Center, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5126-9336","authenticated-orcid":false,"given":"Pranjal","family":"Jain","sequence":"additional","affiliation":[{"name":"Tampa General Hospital, University of South Florida, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3057-6193","authenticated-orcid":false,"given":"James","family":"Lu","sequence":"additional","affiliation":[{"name":"CareDx, Inc, Brisbane, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6210-9341","authenticated-orcid":false,"given":"Martina M.","family":"McGrath","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5501-7617","authenticated-orcid":false,"given":"Mohanram","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Baylor Scott and White Medical Center, Temple, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0290-4719","authenticated-orcid":false,"given":"Anup M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Cooperman Barnabas Medical Center, Livingston, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3979-3418","authenticated-orcid":false,"given":"Massini","family":"Merzkani","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Washington University in St. Louis, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0749-7342","authenticated-orcid":false,"given":"Nitipong","family":"Permpalung","sequence":"additional","affiliation":[{"name":"Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3325-3090","authenticated-orcid":false,"given":"Rashikh A.","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Department of Surgery\u2013Transplant, University of Colorado Hospital, Denver, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3426-0794","authenticated-orcid":false,"given":"Michelle A.","family":"Josephson","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0147-0138","authenticated-orcid":false,"given":"Sanjiv","family":"Anand","sequence":"additional","affiliation":[{"name":"Intermountain Healthcare, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5234-6722","authenticated-orcid":false,"given":"Pradeep","family":"Vaitla","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3570-6831","authenticated-orcid":false,"given":"Eric","family":"Langewisch","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Nephrology, University of Nebraska, Omaha, Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2173-7568","authenticated-orcid":false,"given":"Maria","family":"Ajaimy","sequence":"additional","affiliation":[{"name":"Montefiore-Einstein Center for Transplantation, Montefiore Medical Center, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6816-9297","authenticated-orcid":false,"given":"Dhiren","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6888-2842","authenticated-orcid":false,"given":"George W.","family":"Burke","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine, Miami Transplant Institute, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7130-4800","authenticated-orcid":false,"given":"Todd E.","family":"Pesavento","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4758-6582","authenticated-orcid":false,"given":"Anthony J.","family":"Langone","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5854-7688","authenticated-orcid":false,"given":"Yihung","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Transplant Nephrology, UC Davis Health System, Davis, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5932-3918","authenticated-orcid":false,"given":"David","family":"Leeser","sequence":"additional","affiliation":[{"name":"ECU\/Vidant Medical Center, Greenville, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6625-9240","authenticated-orcid":false,"given":"Bernard","family":"Fischbach","sequence":"additional","affiliation":[{"name":"Baylor University Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4750-4638","authenticated-orcid":false,"given":"Nadiesda","family":"Costa","sequence":"additional","affiliation":[{"name":"MedStar Georgetown Transplant Institute, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5521-5619","authenticated-orcid":false,"given":"Kalathil","family":"Sureshkumar","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Medicine Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3216-133X","authenticated-orcid":false,"given":"Abd A.","family":"Qannus","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, The University of Arizona, Tucson, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-0118","authenticated-orcid":false,"given":"Chun-Po Steve","family":"Fan","sequence":"additional","affiliation":[{"name":"CareDx, Inc, Brisbane, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9752-0050","authenticated-orcid":false,"given":"Ziad","family":"Zaky","sequence":"additional","affiliation":[{"name":"Department of Kidney Medicine, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8709-3857","authenticated-orcid":false,"given":"Fuad","family":"Shihab","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0835-7907","authenticated-orcid":false,"given":"Sanjay","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2856-3991","authenticated-orcid":false,"given":"Thin Thin","family":"Maw","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Keck Medicine of USC, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2378-9302","authenticated-orcid":false,"given":"Bekir","family":"Tanriover","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, The University of Arizona, Tucson, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1341-5144","authenticated-orcid":false,"given":"Enver","family":"Akalin","sequence":"additional","affiliation":[{"name":"Montefiore-Einstein Center for Transplantation, Montefiore Medical Center, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3438-9638","authenticated-orcid":false,"given":"Matthew","family":"Cooper","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6605-6088","authenticated-orcid":false,"given":"Ibrahim","family":"Tawhari","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, College of Medicine, University of Illinois, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8820-5702","authenticated-orcid":false,"given":"Matthew R.","family":"Weir","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4289-0817","authenticated-orcid":false,"given":"Tarek","family":"Alhamad","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Washington University in St. Louis, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4818-7455","authenticated-orcid":false,"given":"Daniel C.","family":"Brennan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3279-2930","authenticated-orcid":false,"given":"Nicolae","family":"Leca","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Washignton, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1668-2005","authenticated-orcid":false,"given":"Suphamai","family":"Bunnapradist","sequence":"additional","affiliation":[{"name":"Division of Nephrology, David Geffen School of Medicine, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7224-0892","authenticated-orcid":false,"given":"Ling","family":"Shen","sequence":"additional","affiliation":[{"name":"CareDx, Inc, Brisbane, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7514-498X","authenticated-orcid":false,"given":"Robert N.","family":"Woodward","sequence":"additional","affiliation":[{"name":"CareDx, Inc, Brisbane, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2210-7311","authenticated-orcid":false,"given":"Peale","family":"Chuang","sequence":"additional","affiliation":[{"name":"CareDx, Inc, Brisbane, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7881-2162","authenticated-orcid":false,"given":"Prince","family":"Anand","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina, Lancaster, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1492-5103","authenticated-orcid":false,"given":"Emilio D.","family":"Poggio","sequence":"additional","affiliation":[{"name":"Department of Kidney Medicine, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4098-4652","authenticated-orcid":false,"given":"Giselle","family":"Guerra","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine, Miami Transplant Institute, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8619-0938","authenticated-orcid":false,"given":"Alexander","family":"Wiseman","sequence":"additional","affiliation":[{"name":"AdventHealth Transplant Institute, Denver, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5565-3533","authenticated-orcid":false,"given":"Anil","family":"Paramesh","sequence":"additional","affiliation":[{"name":"Tulane University School of Medicine, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7631-4195","authenticated-orcid":false,"given":"Diane","family":"Cibrik","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas, Kansas City, Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1407-8795","authenticated-orcid":false,"given":"Jonathan","family":"Bromberg","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the KOAR Study Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"issue":"8","key":"B1-20260713","doi-asserted-by":"crossref","first-page":"2824","DOI":"10.1111\/ajt.16463","article-title":"Long-term kidney transplant graft survival\u2014Making progress when most needed","volume":"21","author":"Poggio","year":"2021","journal-title":"Am J Transplant."},{"issue":"8","key":"B2-20260713","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1056\/NEJMra2014530","article-title":"Long-term survival after kidney transplantation","volume":"385","author":"Hariharan","year":"2021","journal-title":"N Engl J Med."},{"issue":"2","key":"B3-20260713","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1681\/ASN.0000000000000260","article-title":"Prognostic biomarkers in kidney transplantation: a systematic review and critical appraisal","volume":"35","author":"Raynaud","year":"2024","journal-title":"J Am Soc Nephrol."},{"issue":"5","key":"B4-20260713","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/j.kint.2024.07.027","article-title":"Evaluation of non-invasive biomarkers of kidney allograft rejection in a prospective multicenter unselected cohort study (EU-TRAIN)","volume":"106","author":"Goutaudier","year":"2024","journal-title":"Kidney Int."},{"issue":"8","key":"B5-20260713","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1056\/NEJMoa2408835","article-title":"Microvascular inflammation of kidney allografts and clinical outcomes","volume":"392","author":"Sablik","year":"2025","journal-title":"N Engl J Med."},{"issue":"7","key":"B6-20260713","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1016\/j.ajt.2025.03.031","article-title":"Microvascular inflammation in kidney allografts: new directions for patient management","volume":"25","author":"B\u00f6hmig","year":"2025","journal-title":"Am J Transplant."},{"issue":"7","key":"B7-20260713","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1681\/ASN.2016091034","article-title":"Cell-free DNA and active rejection in kidney allografts","volume":"28","author":"Bloom","year":"2017","journal-title":"J Am Soc Nephrol."},{"issue":"8","key":"B8-20260713","doi-asserted-by":"crossref","first-page":"2320","DOI":"10.1038\/s41591-024-03087-3","article-title":"Cell-free DNA for the detection of kidney allograft rejection","volume":"30","author":"Aubert","year":"2024","journal-title":"Nat Med."},{"issue":"4","key":"B9-20260713","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.kint.2021.11.034","article-title":"Clinical outcomes from the assessing donor-derived cell-free DNA monitoring insights of kidney allografts with longitudinal surveillance (ADMIRAL) study","volume":"101","author":"Bu","year":"2022","journal-title":"Kidney Int."},{"issue":"12","key":"B10-20260713","doi-asserted-by":"crossref","first-page":"2529","DOI":"10.1016\/j.ajt.2025.07.2484","article-title":"Donor-derived cell-free DNA significantly improves rejection yield in kidney transplant biopsies","volume":"25","author":"Bromberg","year":"2025","journal-title":"Am J Transplant."},{"issue":"11","key":"B11-20260713","doi-asserted-by":"crossref","first-page":"e70019","DOI":"10.1111\/ctr.70019","article-title":"Changes in donor-derived cell-free DNA before and after rejection and de novo DSA detection in primary and repeat kidney transplant recipients","volume":"38","author":"Parajuli","year":"2024","journal-title":"Clin Transplant."},{"issue":"9","key":"B12-20260713","doi-asserted-by":"crossref","first-page":"2491","DOI":"10.1111\/ajt.15822","article-title":"High levels of dd-cfDNA identify patients with TCMR 1A and borderline allograft rejection at elevated risk of graft injury","volume":"20","author":"Stites","year":"2020","journal-title":"Am J Transplant."},{"issue":"4","key":"B13-20260713","doi-asserted-by":"crossref","first-page":"729","DOI":"10.34067\/KID.0000042021","article-title":"Dynamic response of donor-derived cell-free DNA following treatment of acute rejection in kidney allografts","volume":"2","author":"Wolf-Doty","year":"2021","journal-title":"Kidney360."},{"issue":"6","key":"B14-20260713","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/j.jmoldx.2016.07.003","article-title":"Validation of a clinical-grade assay to measure donor-derived cell-free DNA in solid organ transplant recipients","volume":"18","author":"Grskovic","year":"2016","journal-title":"J Mol Diagn."},{"issue":"9","key":"B15-20260713","doi-asserted-by":"crossref","first-page":"2318","DOI":"10.1111\/ajt.15898","article-title":"The Banff 2019 kidney meeting report (I): updates on and clarification of criteria for T cell\u2013 and antibody-mediated rejection","volume":"20","author":"Loupy","year":"2020","journal-title":"Am J Transplant."},{"issue":"3","key":"B16-20260713","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1007\/s40471-022-00291-y","article-title":"The utility of multistate models: a flexible framework for time-to-event data","volume":"9","author":"Le-Rademacher","year":"2022","journal-title":"Curr Epidemiol Rep."},{"key":"B17-20260713","doi-asserted-by":"crossref","first-page":"e071349","DOI":"10.1136\/bmj-2022-071349","article-title":"Bias by censoring for competing events in survival analysis","volume":"378","author":"Coemans","year":"2022","journal-title":"BMJ."},{"issue":"5","key":"B18-20260713","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1053\/j.ajkd.2025.06.016","article-title":"Transition of care of kidney recipients from transplant centers to referring nephrologists: report from the American Society of transplantation controversies conference","volume":"86","author":"Anand","year":"2025","journal-title":"Am J Kidney Dis."},{"issue":"2","key":"B19-20260713","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1681\/ASN.2021091191","article-title":"The trifecta study: comparing plasma levels of donor-derived cell-free DNA with the molecular phenotype of kidney transplant biopsies","volume":"33","author":"Halloran","year":"2022","journal-title":"J Am Soc Nephrol."},{"issue":"9","key":"B20-20260713","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1097\/TP.0000000000005403","article-title":"Donor-derived cell-free DNA as a noninvasive biomarker of kidney allograft rejection in pediatric kidney transplantation","volume":"109","author":"Hogan","year":"2025","journal-title":"Transplantation."},{"issue":"1","key":"B21-20260713","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1186\/s12879-024-09821-z","article-title":"The simultaneous presence of active BK, Epstein Barr, and human cytomegalovirus infection and their correlation by host factors in patients suspected of kidney transplant rejection","volume":"24","author":"Eslami Kojidi","year":"2024","journal-title":"BMC Infect Dis."},{"issue":"9","key":"B22-20260713","doi-asserted-by":"crossref","first-page":"111736","DOI":"10.1016\/j.celrep.2022.111736","article-title":"Spatial transcriptomics demonstrates the role of CD4 T cells in effector CD8 T cell differentiation during chronic viral infection","volume":"41","author":"Topchyan","year":"2022","journal-title":"Cell Rep."},{"issue":"6","key":"B23-20260713","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1111\/ajt.14169","article-title":"Relationship among viremia\/viral infection, alloimmunity, and nutritional parameters in the first year after pediatric kidney transplantation","volume":"17","author":"Ettenger","year":"2017","journal-title":"Am J Transplant."},{"issue":"5","key":"B24-20260713","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1097\/TP.0000000000003838","article-title":"Correlation of donor-derived cell-free DNA with histology and molecular diagnoses of kidney transplant biopsies","volume":"106","author":"Gupta","year":"2022","journal-title":"Transplantation."},{"issue":"8","key":"B25-20260713","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1097\/TP.0000000000005296","article-title":"Tissue-based gene expression diagnosis of mild and moderate T-cell-mediated rejection to guide therapy in kidney transplants","volume":"109","author":"Kumar","year":"2025","journal-title":"Transplantation."},{"issue":"2","key":"B26-20260713","doi-asserted-by":"crossref","first-page":"e1273","DOI":"10.1097\/TXD.0000000000001273","article-title":"Death with function and graft failure after kidney transplantation: risk factors at baseline suggest new approaches to management","volume":"8","author":"Merzkani","year":"2022","journal-title":"Transplant Direct."},{"issue":"6","key":"B27-20260713","doi-asserted-by":"crossref","first-page":"2364","DOI":"10.3390\/jcm12062364","article-title":"Non-traditional non-immunological risk factors for kidney allograft loss-opinion","volume":"12","author":"Andrian","year":"2023","journal-title":"J Clin Med."},{"issue":"12","key":"B28-20260713","doi-asserted-by":"crossref","first-page":"2887","DOI":"10.1681\/ASN.2020050566","article-title":"Death after kidney transplantation: an analysis by era and time post-transplant","volume":"31","author":"Ying","year":"2020","journal-title":"J Am Soc Nephrol."},{"issue":"25","key":"B29-20260713","doi-asserted-by":"crossref","first-page":"2562","DOI":"10.1056\/NEJMoa067411","article-title":"Reduced exposure to calcineurin inhibitors in renal transplantation","volume":"357","author":"Ekberg","year":"2007","journal-title":"N Engl J Med."},{"issue":"8","key":"B30-20260713","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.2215\/CJN.15040920","article-title":"Long-term immunosuppression management opportunities and uncertainties","volume":"16","author":"Wojciechowski","year":"2021","journal-title":"Clin J Am Soc Nephrol."},{"issue":"12","key":"B31-20260713","doi-asserted-by":"crossref","first-page":"2565","DOI":"10.1016\/j.ajt.2025.07.2474","article-title":"Therapeutic needs in solid organ transplant recipients: the American society of transplantation patient survey","volume":"25","author":"Taber","year":"2025","journal-title":"Am J Transplant."},{"issue":"1","key":"B32-20260713","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1002\/phar.2481","article-title":"Immunosuppression trends in solid organ transplantation: the future of individualization, monitoring, and management","volume":"41","author":"Pilch","year":"2021","journal-title":"Pharmacotherapy."},{"issue":"2","key":"B33-20260713","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s40472-015-0052-y","article-title":"The cost of transplant immunosuppressant therapy: is this sustainable?","volume":"2","author":"James","year":"2015","journal-title":"Curr Transplant Rep."},{"issue":"10501","key":"B34-20260713","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/S0140-6736(25)00195-3","article-title":"Advancing patient monitoring, diagnostics, and treatment strategies for transplant precision medicine","volume":"406","author":"Loupy","year":"2025","journal-title":"Lancet."},{"issue":"1","key":"B35-20260713","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.ajt.2025.08.029","article-title":"Improving the histologic detection of donor-specific antibody-negative antibody-mediated rejection in kidney transplants","volume":"26","author":"Hidalgo","year":"2026","journal-title":"Am J Transplant."}],"container-title":["Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1681\/ASN.0000001133","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T19:31:30Z","timestamp":1786131090000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1681\/ASN.0000001133"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":35,"URL":"https:\/\/doi.org\/10.1681\/asn.0000001133","relation":{},"ISSN":["1046-6673","1533-3450"],"issn-type":[{"value":"1046-6673","type":"print"},{"value":"1533-3450","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]},"assertion":[{"value":"2025-11-26","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}