{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T13:38:56Z","timestamp":1780407536566,"version":"3.54.1"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"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":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["Transpl. Int."],"abstract":"<jats:p>Donor-derived cell free DNA (dd-cfDNA) is an established biomarker for detection of rejection in single organ transplants; data is limited in multi-organ transplant (MOT) recipients. \u201cUse of dd-cfDNA in Multi-Organ Transplant Recipients\u201d (MOTR) was a multicenter, prospective, cross-sectional study that assessed dd-cfDNA fraction (%) and donor quantity score (DQS, cp\/mL) in pancreas-kidney (PKT), heart-kidney (HKT), and liver-kidney (LKT) recipients. We explored dd-cfDNA baseline levels across the different organ combinations, and compared them to kidney-only (KT) and heart-only (HT) transplant recipients. Among 347 MOT recipients from 18 sites (PKT = 183, HKT = 57, LKT = 107), most (88.2%) had simultaneous transplants. Median dd-cfDNA levels in PKT and HKT recipients were not significantly different from KT; median dd-cfDNA levels among HKT recipients were significantly higher than in HT recipients (p &amp;lt; 0.001). In LKT recipients, median dd-cfDNA was significantly higher compared to KT (p &amp;lt; 0.001). dd-cfDNA showed associations with organ impairment indicated by abnormal values of pancreatic and liver enzymes in PKT and LKT. As the largest multi-center study to date evaluating dd-cfDNA levels in MOT recipients, MOTR showed that organ-specific physiology affects dd-cfDNA levels across organ transplant combinations, laying the foundation for future efforts to use dd-cfDNA to assess organ-specific signatures of allograft injury in MOT recipients.<\/jats:p>","DOI":"10.3389\/ti.2025.15823","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T09:12:13Z","timestamp":1768813933000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Donor-Derived Cell-Free DNA in Pancreas-Kidney, Heart-Kidney, and Liver-Kidney Multiorgan Transplant Recipients (MOTR)"],"prefix":"10.3389","volume":"38","author":[{"given":"Gaurav","family":"Gupta","sequence":"first","affiliation":[{"name":"Virginia Commonwealth University","place":["Richmond, VA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Wojciechowski","sequence":"additional","affiliation":[{"name":"UT Southwestern Medical Center","place":["Dallas, TX, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alp","family":"Sener","sequence":"additional","affiliation":[{"name":"Western University, Schulich School of Medicine and Dentistry","place":["London, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Gong","sequence":"additional","affiliation":[{"name":"Baylor University Medical Center","place":["Dallas, TX, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ty B.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadiesda","family":"Costa","sequence":"additional","affiliation":[{"name":"MedStar Georgetown University Hospital","place":["Washington, DC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon S.","family":"Odorico","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin","place":["Milwaukee, WI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"Daloul","sequence":"additional","affiliation":[{"name":"The Ohio State University","place":["Columbus, OH, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinayak S.","family":"Rohan","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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