dc.contributor.advisor | Oellerich, Michael Prof. Dr. Dr. | |
dc.contributor.author | Fischer, Anna | |
dc.date.accessioned | 2020-02-18T13:03:19Z | |
dc.date.available | 2020-02-25T23:50:02Z | |
dc.date.issued | 2020-02-18 | |
dc.identifier.uri | http://hdl.handle.net/21.11130/00-1735-0000-0005-1325-C | |
dc.identifier.uri | http://dx.doi.org/10.53846/goediss-7852 | |
dc.language.iso | deu | de |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.subject.ddc | 610 | de |
dc.title | Zirkulierende zellfreie Transplantat-DNA zur Früherkennung einer Abstoßung in der Lebertransplantation | de |
dc.type | doctoralThesis | de |
dc.title.translated | Graft-derived cell-free DNA – an early rejection marker in liver transplantation | de |
dc.contributor.referee | Oellerich, Michael Prof. Dr. Dr. | |
dc.date.examination | 2020-02-18 | |
dc.description.abstracteng | Graft-derived cell-free DNA (GcfDNA) is a promising non-invasive organ integrity biomarker. In a prospective, observational, multicenter trial plasma GcfDNA was investigated in 115 adults post liver transplantation (LTx) at three German transplant centers. GcfDNA was highly elevated (>50%) on day one post-LTx, presumably due to ischemia/reperfusion damage, but rapidly decreased in patients without graft injury within 7 to 10 days to a median <10% baseline where it remained for the one year observation period. GcfDNA values were highly elevated (median 29.6%, 95% CI 23.6%–41.0%) in 31 samples during 17 biopsy-proven acute rejection episodes compared to 282 samples from 88 patients during stable periods (median 3.3%, 95% CI 2.9%–3.7%; p < 0.001), whereas only slightly higher values were found in 68 samples from 17 Hepatitis C (HCV+) patients (median 5.9%, 95% CI 4.4%–10.3%). Traditional liver function tests (LFTs) had low overall correlations (r = 0.28–0.62) with GcfDNA and greater overlap between acute rejection, HCV+ patients, and stable periods. Diagnostic sensitivity and specificity were 90.3% (95% CI 74.2%–98.0%) and 92.9% (95% CI 89.3%–95.6%) respectively, for GcfDNA at a threshold value of 10%. The area under the receiver operator characteristic curve for GcfDNA ((97.1%, 95% CI 93.4%–100%) was highest compared to same day conventional LFTs. Conclusion: In this study, determination of GcfDNA in plasma by ddPCR allowed for earlier and more sensitive discrimination of acute rejection in LTx patients as compared with conventional LFTs. | de |
dc.contributor.coReferee | Lorf, Thomas PD Dr. | |
dc.subject.eng | graft-derived cell-free DNA | de |
dc.subject.eng | liver transplantation | de |
dc.subject.eng | rejection biomarker | de |
dc.subject.eng | digital droplet PCR | de |
dc.subject.eng | GcfDNA | de |
dc.subject.eng | liquid biopsy | de |
dc.identifier.urn | urn:nbn:de:gbv:7-21.11130/00-1735-0000-0005-1325-C-6 | |
dc.affiliation.institute | Medizinische Fakultät | de |
dc.subject.gokfull | Chirurgie - Allgemein- und Gesamtdarstellungen (PPN619875968) | de |
dc.subject.gokfull | Diagnostik {Medizin} (PPN619875739) | de |
dc.description.embargoed | 2020-02-25 | |
dc.identifier.ppn | 169032418X | |