biostudies-literaturePark SNational Institute of Allergy and Infectious DiseasesNIDDK NIH HHSNational Institute of Diabetes and Digestive and Kidney DiseasesNIAID NIH HHS1539-1551https://www.ebi.ac.uk/biostudies/studies/S-EPMC8499014biostudies-literatureUnknown16(10)<h4>Background and objectives</h4>Subclinical acute rejection is associated with poor outcomes in kidney transplant recipients. As an alternative to surveillance biopsies, noninvasive screening has been established with a blood gene expression profile. Donor-derived cellfree DNA (cfDNA) has been used to detect rejection in patients with allograft dysfunction but not tested extensively in stable patients. We hypothesized that we could complement noninvasive diagnostic performance for subclinical rejection by combining a donor-derived cfDNA and a gene expression profile assay.<h4>Design, setting, participants, & measurements</h4>We performed a <i>post hoc</i> analysis of simultaneous blood gene expression profile and donor-derived cfDNA assays in 428 samples paired with surveillance biopsiesClinical journal of the American Society of Nephrology : CJASNCombining Blood Gene Expression and Cellfree DNA to Diagnose Subclinical Rejection in Kidney Transplant Recipients.PMC84990143U01 AI063594‐07S1U01 AI063594T32DK1087382U19 AI063603R34 AI118493T32 DK108738U01 AI0841461U01AI088635Abecassis MMFriedewald JJPark SHeilman RLBrietigam SGuo KZhao LSinha RMarsh CLTaber DJKleiboeker SWeems JPoggio EDKurian SMHolman JRebello CfalseCombining Blood Gene Expression and Cellfree DNA to Diagnose Subclinical Rejection in Kidney Transplant Recipients.<h4>Background and objectives</h4>Subclinical acute rejection is associated with poor outcomes in kidney transplant recipients. As an alternative to surveillance biopsies, noninvasive screening has been established with a blood gene expression profile. Donor-derived cellfree DNA (cfDNA) has been used to detect rejection in patients with allograft dysfunction but not tested extensively in stable patients. We hypothesized that we could complement noninvasive diagnostic performance for subclinical rejection by combining a donor-derived cfDNA and a gene expression profile assay.<h4>Design, setting, participants, & measurements</h4>We performed a <i>post hoc</i> analysis of simultaneous blood gene expression profile and donor-derived cfDNA assays in 428 samples paired with surveillance biopsies2021-01-01T00:00:00Z2021 Oct2026-05-31T02:13:36.752Z2025-02-19T01:22:16.73ZS-EPMC84990143462064910.2215/cjn.0553042110.2215/CJN.05530421