Blood Test Shows Promise for Early Detection of Severe Lung-Transplant Rejection

Researchers have developed a simple blood test that can detect when a newly transplanted lung is being rejected by a patient, even when no outward signs of the rejection are evident. The test could make it possible for doctors to intervene faster to prevent or slow down so-called chronic rejection—which is severe, irreversible and often deadly—in those first critical months after lung transplantation. Researchers believe this same test might also be useful for monitoring rejection in other types of organ transplants. The work was funded by NHLBI; the study’s findings were published Jan. 22 in EBioMedicine, a publication of The Lancet.

“This test solves a long-standing problem in lung transplants: detection of hidden signs of rejection,” said Dr. Hannah Valantine, co-leader of the study and lead investigator of NHLBI’s Laboratory of Organ Transplant Genomics in the Cardiovascular Branch. “We’re very excited about its potential to save lives, especially in the wake of a critical shortage of donor organs.”

The test relies on DNA sequencing, Valantine explained, and as such, represents a great example of personalized medicine, as it will allow doctors to tailor transplant treatments to those individuals who are at highest risk for rejection.

Lung transplant recipients have the shortest survival rates among patients who get solid organ transplantation of any kind—only about half live past 5 years. Lung transplant recipients face a high incidence of chronic rejection, which occurs when the body’s immune system attacks the transplanted organ. Existing tools for detecting signs of rejection, such as biopsy, either require the removal of small amounts of lung tissue or are not sensitive enough to discern the severity of the rejection. The new test, called the donor-derived cell-free DNA test, appears to overcome those challenges.