Circulating donor-derived cell-free DNA: a true biomarker for cardiac allograft rejection?

Heart transplantation remains a lifesaving therapy for adults and children with end-stage heart disease. Since the first heart transplant was performed in 1967, advances in peri-operative care and long term immunosuppression have dramatically improved post-transplant outcomes (1). Currently, adult recipients can expect a median allograft survival of greater than 10 years and infant recipients can expect a median allograft survival that is greater than 20 years (2,3).