Donor-Derived Cell-Free DNA for Surveillance in Simultaneous Pancreas and Kidney Transplant Recipients

This is a prospective and retrospective cohort study of recipients of simultaneous pancreas and kidney transplant recipients (SPK). New SPK transplant recipients and previous SPK transplant recipients from September 2012 will be enrolled in the study, expected duration of participation will therefore range from a minimum of 1 year to a maximum of 5 years for each participant. The visits are incorporated into the current standard of care in our program and no extra visits are required. Mobile draw for AlloSure can be obtained if the patient is not due for a visit when the AlloSure draw is due. AlloSure labs will be drawn on all new SPK patients and results obtained as well as retrospective results that have already been received on past SPK recipients. The AlloSure will be added to the standard of care schedule for all SPK patients. The schedule will be the following: For newly transplanted patients, AlloSure will be checked at 14 days post-transplant For all subjects: From 1 month to 12 months post transplant: AlloSure will be obtained monthly with their transplant date as the reference time point From 12 months to 36 months: AlloSure will be obtained every 3 months From 36 months to 60 months: AlloSure will be obtained every 6 months. AlloSure may be obtained more frequently than the above schedule, with other clinical data or allograft biopsy, if there is graft dysfunction or suspicion for rejection.