Application of graft-derived cell-free DNA in ornithine transcarbamylase deficiency patient after living donor liver transplantation Two case reports

作者：Ng, Hoi-Ioi; Sun, Li-Ying; Zhu, Zhi-Jun^*

来源：Medicine, 2018, 97(51): e13843.

DOI：10.1097/MD.0000000000013843

• graft injury
• graft-derived cell-free DNA
• living donor liver transplantation
• Y-chromosome method

Rationale: Graft-derived-cell-free DNA (Gcf-DNA) in plasma was a promising biomarker to monitor graft-rejection transplantation. However, little is known about the application of Gcf-DNA in living-donor-liver-transplantation (LDLT).
Patients concern: In this study. 2 patients diagnosed with Ornithine Transcarbamylase Deficiency (OTCD) were enrolled and indicated for LDLT.
Diagnoses: Two patients were genetically diagnosed with OTCD, and they suffered from recurrent and uncontrollable hyper-ammonemia and failed in accepting the normalized OTCD treatments, such as decreasing dietary nitrogen intake and increasing waste-nitrogen excretion.
Interventions: LDLT was performed in the 2 patients uneventfully, and we collected circulating cell-free DNA from plasma in specific postoperative time points (day 1, day 7, day 14, day 30, day 60). Since both of the recipients were sex-mismatch with the donors, we measured Gcf-DNA through the Y-chromosome method and compared it with the routine liver function.
Outcomes: The result showed that Gcf-DNA had the similar discrimination of graft injury trend while compared to routine liver function. The follow-up showed these 2 patients' status is stable.
Lessons: Applying Gcf-DNA to monitor graft injury in LDLT is promising, but still long term follow-up and more samples are needed for validation.

• 出版日期2018-12
• 单位首都医科大学