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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Dec 18, 2025; 15(4): 104349
Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.104349
Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.104349
Utility and limitations of the use of donor-derived cell-free DNA in kidney transplantation
Maurizio Salvadori, Department of Renal Transplantation, Careggi University Hospital, Florence 50139, Tuscany, Italy
Giuseppina Rosso, Department of Nephrology, San Giovanni di Dio Hospital, Florence 50143, Toscana, Italy
Co-first authors: Maurizio Salvadori and Giuseppina Rosso.
Author contributions: Salvadori M and Rosso G wrote, revised and approved the manuscript, they contributed equally to this article, they are the co-first authors of this manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maurizio Salvadori, MD, Professor, Department of Renal Tran
Received: December 18, 2024
Revised: March 20, 2025
Accepted: April 8, 2025
Published online: December 18, 2025
Processing time: 336 Days and 15.7 Hours
Revised: March 20, 2025
Accepted: April 8, 2025
Published online: December 18, 2025
Processing time: 336 Days and 15.7 Hours
Core Tip
Core Tip: New biomarkers have allowed to improving our knowledge in clinical medicine, in the field of transplantation in particular. Donor-derived cell-free DNA has proven to be one of the best. Such donor DNA is delivered from the damaged graft into the bloodstream of the recipient. The finding of donor-derived cell-free DNA is a clear sign of damaged graft, more often involving the endothelial cells. Several pathologies may be the cause, most often antibody-mediated rejection. Less frequent, T-cell mediated rejection. Major advantage of such technique is to avoid invasive procedures as renal biopsy.