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  "documentTitle": "CareDx, Inc. (CDNA)",
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  "notes": "The slide provides a critical narrative on the efficacy of dd-cfDNA testing, highlighting the gap between academic hope and clinical utility.",
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      "text": "The results don't bode well for AlloSure.",
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      "text": "The idea of quantifying the proportion of dd-cfDNA as a marker of kidney injury was first hypothesized in the late 1990's by Dennis Lo and his team at the Chinese University of Hong Kong.",
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      "text": "In the transplant setting, the goal of a dd-cfDNA test is to quantify the proportion of cfDNA in the transplant recipient's bloodstream that's coming directly from the donated kidney.",
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      "text": "With the achievement of Medicare coverage and reimbursement in mid-2017, large scale subsidized studies of dd-cfDNA became possible. The results don't bode well for AlloSure.",
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      "text": "In the almost-decade since then, hundreds of articles have been written about small-scale experiments in the use of dd-cfDNA to detect organ rejection. These papers can generally be described as hopeful, but inconclusive.",
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      "text": "Although dd-cfDNA is an interesting and promising marker of solid transplant organ health, much work still needs to be done before clinical implementation...",
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      "text": "Although dd-cfDNA is an interesting and promising marker of solid transplant organ health, much work still needs to be done before clinical implementation...In conclusion, whereas observational studies published so far point to dd-cfDNA as a promising marker in the transplantation field, randomized control studies are mandatory comparing a dd-cfDNA-based monitoring strategy with the standard post-transplantation monitoring in terms of graft and patient survival. — American Journal of Transplantation",
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      "text": "12 Snyder TM, et al. Universal noninvasive detection of solid organ transplant rejection. Proc Natl Acad Sci U S A. 2011;108(15):6229–6234. doi: 10.1073/pnas.1013924108.",
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      "text": "13 Gielis EM, et al. Cell-Free DNA: An Upcoming Biomarker in Transplantation. Am J Transplant 2015;15:2541–2551.",
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