GENOMICS
From research to routine practice: advancing dd-cfDNA monitoring
Donor-derived cell-free DNA monitoring is moving into routine use in UK transplant laboratories. Here, Stephanie Anderson reports from a recent event evaluating progress in this area and the wider field of genomics.
In June 2026, Promega hosted the UK’s inaugural Maxwell in Focus user day in London at the Wellcome Collection – a museum and library dedicated to the past, future and present of health. The full-day event brought together scientists, clinicians and researchers, to share learnings and discuss the role of automated nucleic acid extraction in the fast-developing field of genomics. Guest speakers shared their experience of implementing Maxwell technologies into their extraction workflows, covering topics ranging from long-read sequencing and FFPE-sample processing to cell-free DNA analysis for oncology and transplantation, high-throughput workflows, and the translation of genomic technologies into clinical practice.
dd-cfDNA in kidney transplant monitoring Readers may recall that we highlighted North Bristol NHS Trust’s work on donor- derived cell-free DNA (dd-cfDNA) in 2025, when Lead Clinical Scientist Dr Sarinder Day introduced the technology as a promising non-invasive biomarker capable of detecting allograft injury earlier than conventional approaches.1
While kidney
biopsy remains the gold standard for diagnosing rejection, it is invasive and carries risks for patients. Other routine tests like serum creatinine are a measure of kidney function rather than graft injury and an increase in creatinine levels is not specific to allograft injury. By contrast, dd-cfDNA has the potential to provide an
earlier indication of graft injury from a simple blood sample. Building on this earlier work,
Day’s presentation at Maxwell in Focus highlighted the practicalities of implementing the technology within a routine histocompatibility and immunogenetics laboratory. The ongoing pilot study is evaluating the GraftAssureIQ assay while establishing a robust pre- analytical workflow suitable for routine clinical use. Alongside assessing analytical performance, one of the team’s key objectives has been to determine whether automated cfDNA extraction could be
successfully integrated into the existing laboratory workflow. Blood samples were collected in
stabilisation tubes before plasma isolation and automated cfDNA extraction using the Maxwell RSC Rapid ccfDNA kit. The resulting DNA was quantified before analysis using a droplet digital PCR workflow, enabling measurement of both dd-cfDNA and total circulating cfDNA. The complete analytical process can be completed within a working day, allowing results to be available the following day. For Day, one of the key advantages of the workflow was its practicality
Dr Sarinder Day’s presentation covered the practicalities of implementing dd-cfDNA monitoring technology within a routine histocompatibility and immunogenetics laboratory.
September 2026
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