Kidney/Pancreas
Has anyone had very high dd-cfDNA with an unclear diagnosis?
I received a simultaneous kidney-pancreas transplant in June 2021. Over the past year, I have dealt with recurrent abdominal pain, elevated lipase, multiple hospitalizations, and treatment for suspected pancreatic rejection.
In September 2025, my lipase had remained elevated since August. The transplant team treated me with three doses of 500 mg IV Solu-Medrol followed by a prednisone taper. I later received rabbit antithymocyte globulin. My lipase eventually returned to normal, but I have never received a clear explanation of whether the team ultimately concluded that I had pancreas rejection, pancreatitis, both, or something else.
My kidney function also changed after the rejection treatment and has not returned to my previous baseline. In March 2026, my Prospera donor-derived cell-free DNA result was:
- dd-cfDNA: 8.22%
- DQS: 458 cp/mL
- Interpretation: Increased risk for rejection
I understand that dd-cfDNA indicates donor-organ injury, but cannot diagnose rejection or determine whether the injury originated in the kidney, pancreas, or both in a dual-organ recipient.
I continue to experience episodes of abdominal pain and elevated lipase, yet no pancreas biopsy has been performed. I am trying to understand how other transplant centers approach cases like this, not asking anyone here to diagnose me.
For other kidney-pancreas recipients:
- Have you had a markedly elevated dd-cfDNA result?
- How did your team determine which transplanted organ was injured?
- Did you receive a kidney biopsy, pancreas biopsy, or both?
- Were you ever treated for presumed rejection without a biopsy?
- How did your team distinguish pancreas rejection from pancreatitis?
- Did your kidney function establish a new baseline after steroids or ATG?
I am reviewing my records and preparing questions for my transplant nephrologist because I need a clearer understanding of what happened and what the long-term plan is. I'm also considering a second opinion at other hospitals in Kentucky, Ohio, and Minnesota. I would appreciate hearing from anyone who has experienced something similar, especially another simultaneous kidney-pancreas recipient.
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@Karin Karin, maybe you can help Niesha out with this?
@Karin Re-bumping this one!