Serial Donor-Derived Cell-Free DNA (dd-cfDNA) Surveillance Following Immunosuppression Modification in Kidney Transplant Recipients with BK Polyomavirus Viremia

Purpose: Donor-derived cell-free DNA (dd-cfDNA) testing is a noninvasive biomarker, indicated for the surveillance of allograft injury and rejection; complementing standard monitoring in kidney transplant recipients (KTRs). BK polyomavirus (BKPyV) viremia is a common infection after transplantation and can cause allograft injury due to BKPyV associated nephropathy (BKAN) which requires prompt intervention. A multimodal treatment strategy, involving immunosuppression (IS) minimization is required; however, reducing IS may lead to rejection.