DNA testing after transplant

[Farmworld]

My son had his kidney transplant from deceased donor 2/18. Other than a few blood pressure problems he's felt really good. Just recently he's developed a cough more severe when lying down or sitting, his team doesn't seem worried. But his creatinine is creeping up and they want a DNA test. Why?

[Blue-Quilter]

I just joined this community (July 2021) so don't know if you ever got your question answered from your medical team. I'll tell you what I know.

I got my new kidney in October 2019 from a deceased donor. Starting about 3 months post transplant, my transplant nephrologist ordered an Allosur test to look for the donor's DNA. There will be some of the donor's DNA present as the organ didn't originate in my body, but as long as it stays below a certain level (which I have forgotten, but maybe 1%?) you're considered at a low risk of rejection. They repeated the test every three months for the first 18 months, and likely will do it at my two year check in October of this year.

I'm not sure how the cough your son developed could be related, but the rising creatinine means declining function. That could be related to the beginning of a rejection episode. Or it could simply mean he's not drinking enough water. If you haven't gotten an answer yet, definitely bring it up the next time you see the medical team. Best wishes!

[Pandle]

A cough can be from ACE inhibitors. I hope all turns out to be well.

[Falkenhayn in reply to Pandle]

The real question with the rise in creatinine levels is how much? Normally they fluctuate a bit all the time, so as long as the increase is not sudden or large the transplant team will usually not be concerned. My creatinine levels, for example, right after my transplant in 2005 were 130 and rose to 160 over the following 14 years; it was only recently when the creatinine rose to 225 that problems were suspected.