Circulating cell-free DNA methylation patterns indicate cellular sources of allograft injury after liver transplant

Abstract Post-transplant complications reduce allograft and recipient survival. Current approaches for detecting allograft injury non-invasively are limited and do not differentiate between cellular mechanisms. Here, we monitor cellular damages after liver transplants from cell-free DNA (cfDNA) frag...

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Main Authors: Megan E. McNamara, Sidharth S. Jain, Kesha Oza, Vinona Muralidaran, Amber J. Kiliti, A. Patrick McDeed, Digvijay Patil, Yuki Cui, Marcel O. Schmidt, Anna T. Riegel, Alexander Kroemer, Anton Wellstein
Format: Article
Language:English
Published: Nature Portfolio 2025-06-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-60507-9
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author Megan E. McNamara
Sidharth S. Jain
Kesha Oza
Vinona Muralidaran
Amber J. Kiliti
A. Patrick McDeed
Digvijay Patil
Yuki Cui
Marcel O. Schmidt
Anna T. Riegel
Alexander Kroemer
Anton Wellstein
author_facet Megan E. McNamara
Sidharth S. Jain
Kesha Oza
Vinona Muralidaran
Amber J. Kiliti
A. Patrick McDeed
Digvijay Patil
Yuki Cui
Marcel O. Schmidt
Anna T. Riegel
Alexander Kroemer
Anton Wellstein
author_sort Megan E. McNamara
collection DOAJ
description Abstract Post-transplant complications reduce allograft and recipient survival. Current approaches for detecting allograft injury non-invasively are limited and do not differentiate between cellular mechanisms. Here, we monitor cellular damages after liver transplants from cell-free DNA (cfDNA) fragments released from dying cells into the circulation. We analyzed 130 blood samples collected from 44 patients at different time points after transplant. Sequence-based methylation of cfDNA fragments were mapped to an atlas of cell-type-specific DNA methylation patterns derived from 476 methylomes of purified cells. For liver cell types, DNA methylation patterns and multi-omic data integration show distinct enrichment in open chromatin and functionally important regulatory regions. We find that multi-tissue cellular damages post-transplant recover in patients without allograft injury during the first post-operative week. However, sustained elevation of hepatocyte and biliary epithelial cfDNA within the first month indicates early-onset allograft injury. Further, cfDNA composition differentiates amongst causes of allograft injury indicating the potential for non-invasive monitoring and intervention.
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spelling doaj-art-00c748c3a5fa4df1924e7c7654798d4a2025-08-20T02:37:33ZengNature PortfolioNature Communications2041-17232025-06-0116111710.1038/s41467-025-60507-9Circulating cell-free DNA methylation patterns indicate cellular sources of allograft injury after liver transplantMegan E. McNamara0Sidharth S. Jain1Kesha Oza2Vinona Muralidaran3Amber J. Kiliti4A. Patrick McDeed5Digvijay Patil6Yuki Cui7Marcel O. Schmidt8Anna T. Riegel9Alexander Kroemer10Anton Wellstein11Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown UniversityDepartment of Oncology, Lombardi Comprehensive Cancer Center, Georgetown UniversityMedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital and Center for Translational Transplant Medicine, Georgetown University Medical CenterMedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital and Center for Translational Transplant Medicine, Georgetown University Medical CenterDepartment of Oncology, Lombardi Comprehensive Cancer Center, Georgetown UniversityDepartment of Oncology, Lombardi Comprehensive Cancer Center, Georgetown UniversityMedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital and Center for Translational Transplant Medicine, Georgetown University Medical CenterMedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital and Center for Translational Transplant Medicine, Georgetown University Medical CenterDepartment of Oncology, Lombardi Comprehensive Cancer Center, Georgetown UniversityDepartment of Oncology, Lombardi Comprehensive Cancer Center, Georgetown UniversityMedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital and Center for Translational Transplant Medicine, Georgetown University Medical CenterDepartment of Oncology, Lombardi Comprehensive Cancer Center, Georgetown UniversityAbstract Post-transplant complications reduce allograft and recipient survival. Current approaches for detecting allograft injury non-invasively are limited and do not differentiate between cellular mechanisms. Here, we monitor cellular damages after liver transplants from cell-free DNA (cfDNA) fragments released from dying cells into the circulation. We analyzed 130 blood samples collected from 44 patients at different time points after transplant. Sequence-based methylation of cfDNA fragments were mapped to an atlas of cell-type-specific DNA methylation patterns derived from 476 methylomes of purified cells. For liver cell types, DNA methylation patterns and multi-omic data integration show distinct enrichment in open chromatin and functionally important regulatory regions. We find that multi-tissue cellular damages post-transplant recover in patients without allograft injury during the first post-operative week. However, sustained elevation of hepatocyte and biliary epithelial cfDNA within the first month indicates early-onset allograft injury. Further, cfDNA composition differentiates amongst causes of allograft injury indicating the potential for non-invasive monitoring and intervention.https://doi.org/10.1038/s41467-025-60507-9
spellingShingle Megan E. McNamara
Sidharth S. Jain
Kesha Oza
Vinona Muralidaran
Amber J. Kiliti
A. Patrick McDeed
Digvijay Patil
Yuki Cui
Marcel O. Schmidt
Anna T. Riegel
Alexander Kroemer
Anton Wellstein
Circulating cell-free DNA methylation patterns indicate cellular sources of allograft injury after liver transplant
Nature Communications
title Circulating cell-free DNA methylation patterns indicate cellular sources of allograft injury after liver transplant
title_full Circulating cell-free DNA methylation patterns indicate cellular sources of allograft injury after liver transplant
title_fullStr Circulating cell-free DNA methylation patterns indicate cellular sources of allograft injury after liver transplant
title_full_unstemmed Circulating cell-free DNA methylation patterns indicate cellular sources of allograft injury after liver transplant
title_short Circulating cell-free DNA methylation patterns indicate cellular sources of allograft injury after liver transplant
title_sort circulating cell free dna methylation patterns indicate cellular sources of allograft injury after liver transplant
url https://doi.org/10.1038/s41467-025-60507-9
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