Biomarkers in the Management of the Lung Transplant Allograft: A Focus on Donor-derived Cell-free DNA

Advances in the use of molecular biomarkers to guide management of lung transplant recipients are emerging. One such biomarker, donor-derived cell-free DNA (dd-cfDNA), has the potential to alter traditional approaches of lung transplant management, including the detection of acute rejection or infection, surveillance monitoring strategies, risk stratification of vulnerable patient populations and molecular phenotyping of various forms of allograft injury. The emergence of novel genetic and epigenetic approaches utilizing cfDNA provides further promise for the elucidation of pathophysiological mechanisms and treatment targets in various disease states. This review aims to employ the current state of the evidence to cover the biological basis, clinical applications and future directions for the use of dd-cfDNA in lung transplant recipients.