TABLE 2.
Diagnostic performance of plasma dd-cfDNA for detection of rejection in solid organ transplantation.
| Study | Organ | Threshold dd-cfDNA | ROC-AUC | Sensitivity % | Specificity % | PPV a % | NPV a % |
|---|---|---|---|---|---|---|---|
| Bloom 2017 Bloom et al. (2017) | Kidney | 1.00% | 0.74 | 59 | 85 | 61 | 84 |
| Sigdel 2019 Sigdel et al. (2019) | Kidney | 1.00% | 0.87 | 89 | 73 | 52 | 95 |
| Whitlam 2019 Whitlam et al. (2019) | Kidney | 0.75% | 0.89 | 85 | 75 | 48 | 95 |
| 13 cp/ml | 0.91 | 85 | 79 | 52 | 95 | ||
| Oellerich 2019 Oellerich et al. (2019) | Kidney | 0.43% | 0.73 | 73 | 69 | 12 | 98 |
| 52 cp/ml | 0.83 | 73 | 73 | 13 | 98 | ||
| Huang 2019 Huang et al. (2019) | Kidney | 0.74% | 0.71 | 79 | 72 | 77 | 75 |
| Dauber 2020 Dauber et al. (2020) | Kidney | 2.7% | 0.84 | 88 | 81 | 64 | 94 |
| Zhang 2020 Zhang et al. (2020) | Kidney | 1.0% | 0.90 | 89 | 74 | 76 | 88 |
| De Vlaminick 2014 De Vlaminck et al. (2014) | Heart | 0.25% | 0.83 | 58 | 93 | NR | NR |
| Richmond 2020 (Richmond et al. (2020) | Heart | 0.30% | 0.78 | 60 | 92 | 80 | 81 |
| Khush 2019 Khush et al. (2019) | Heart | 0.20% | 0.64 | 44 | 80 | 9 | 97 |
| Agbor-Enoh 2021 Agbor-Enoh et al. (2021a) | Heart | 0.25% | 0.92 | 81 | 85 | 20 | 99 |
| Knüttgen 2022 Knuettgen et al. (2022) | Heart | 0.35% | 0.81 | 76 | 83 | 31 | 97 |
| Kim 2022 Kim et al. (2022) | Heart | 0.15% | 0.86 | 79 | 77 | 25 | 97 |
| Sorbini 2021 Sorbini et al. (2021) | Heart | 0.11% | 0.72 | 64 | 71 | NR | NR |
| De Vlaminck 2015 De Vlaminck et al. (2015) | Lung | 1.0% | 0.90 | 100 | 73 | NR | NR |
| Sayah 2020 Sayah et al. (2020) | Lung | 0.87% | 0.72 | 73 | 53 | 34 | 86 |
| Khush 2021 Khush et al. (2021) | Lung | 0.85% | 0.67 | 56 | 76 | 43 | 84 |
| Jang 2021 Jang et al. (2021) | Lung | 1.0% | 0.89 | 77 | 84 | 60 | 90 |
| Keller 2022 Keller and Agbor-Enoh, (2022) | Lung | 1.0% | 0.79 | 76 | 70 | NR | NR |
| Rosenheck 2022 Rosenheck et al. (2022b) | Lung | 1.0% | 0.91 | 89 | 83 | 52 | 97 |
| Schütz 2017 Schuetz et al. (2017) | Liver | 10% | 0.97 | 90 | 93 | NR | NR |
| Levitsky 2021 Levitsky et al. (2022) | Liver | 5% | 0.95 | 100 | 80 | 63 | 100 |
| Baumann 2022 Baumann et al. (2022) | Liver | 10% | 0.92 | 81 | 91 | NR | NR |
| Ventura-Aguiar 2022 Ventura-Aguiar et al. (2022) | Pancreas-kidney | 10% | 0.84 | 29 | 100 | NR | NR |
| 70 cp/ml | 0.89 | 86 | 94 | 86 | 94 |
NR, not reported.
a
Predictive values also depend on the variable prevalence of rejection in the study populations. Examples for variable acute rejection incidence are given in Ref (Kataria et al., 2021).