Table 2 Clinical applications and significance of dd-cfDNA in liver transplantation

Early Diagnosis of AR

Early in acute rejection, dd-cfDNA shows a significant increase, usually higher than the normal range

Can serve as an early warning signal for acute rejection, providing higher sensitivity and earlier diagnostic capability compared to traditional liver biopsy

[5]

Monitoring of Graft Function

Positively correlated with the recovery or deterioration of liver function, particularly with the levels of ALT and AST

Can be used to monitor liver damage or functional recovery in real time, overcoming the limitations of traditional biochemical tests and biopsies

[3]

Prediction of IRI

Rise rapidly and are correlated with the severity of the damage

Predict the occurrence of IRI and its impact on liver function, offering an opportunity for early intervention

[51]

Infection Monitoring and Complication Diagnosis

In cases of infection or other complications, dd-cfDNA levels often increase significantly

Help identify bacterial or viral infections after transplantation

[52]

Long-term Monitoring and Prognostic Assessment

Are associated with chronic rejection and chronic graft dysfunction

Not only for short-term monitoring, but also for the prediction of long-term post-transplant rejection and chronic liver failure

[11]