“Having seen the impact of cell-free DNA technology across various fields, I recognize its powerful potential in transforming patient care.
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David Wojciechowski

Professor of Medicine,
Medical Director Kidney Transplantation

Dallas, TX

“Having seen the impact of cell-free DNA technology across various fields, I recognize its powerful potential in transforming patient care.

Learn more about the importance of surveillance testing

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ProsperaTM Surveillance
Testing in Action

Learn more about the importance of surveillance testing

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Overcoming Barriers

Explore resources available for successfully transitioning to ProsperaTM

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Why Natera?

Explore Natera’s extensive experience with cell-free DNA

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How ProsperaTM Works

See how ProsperaTM works and the data behind it

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Having seen the impact of cell-free DNA technology across various fields, I recognize its powerful potential in transforming patient care.

KOL Image KOL Image KOL Image

Having seen the impact of cell-free DNA technology across various fields, I recognize its powerful potential in transforming patient care.

David Wojciechowski

Professor of Medicine,
Medical Director Kidney Transplantation

Dallas, TX

ProsperaTM is a proven leading indicator of rejection1-3

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Predicted antibody-mediated rejection (ABMR) up to five months and T cell-mediated rejection (TCMR) up to two months in advance of biopsy-proven rejection1

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Increased ProsperaTM levels in non-rejecting patients are associated with worsening clinical graft function

Blood Vile graphic

Consistent ProsperaTM performance across validations and real-world settings to benefit any patient population1-3

The ProsperaTM test predicted ABMR up to 5 months and TCMR up to 2 months in advance of biopsy-proven rejection1

ProsperaTM dd-cfDNA levels versus serum creatinine prior to biopsy-proven rejection

Image illustrating Prospera TM dd-cfDNA levels versus serum creatinine prior to biopsy-proven rejection Image illustrating Prospera TM dd-cfDNA levels versus serum creatinine prior to biopsy-proven rejection

Increased ProsperaTM levels in non-rejecting patients are associated with worsening clinical graft function1,4

Image illustrating Increased Prospera TM levels in non-rejecting patients are associated with worsening clinical graft function

Two or more elevated ProsperaTM tests in a patient were correlated with worse eGFR.

This observation is consistent with recent findings indicating that elevated ProsperaTM result in non-rejection biopsies is often associated with sub-threshold ABMR and should therefore not be considered a false positive.

The interim ProActive study data solidifies ProsperaTM use as a non-invasive surveillance tool1,2,5,6

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~9 out of every 10 clinically stable patients had consistently low ProsperaTM dd-cfDNA levels <1%5

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Elevation of cfDNA from baseline when using serial ProsperaTM testing indicated increased risk of rejection6

ProsperaTM surveillance testing in action: The Donor Quantity Score (DQS) difference in patient care

Case: Diagnosing ABMR due to serial ProsperaTM with DQS finding

Old lady cartoon headshot

Patient
demographics

  • Female in mid-70s
  • High risk due to high CPRA; previous history of biopsy-proven ABMR

ProsperaTM test
summary

ProsperaTM Draw ~1 year
post-tx		 ~13 months
post-tx		 ~16 months
post-tx		 ~18 months
post-tx		 ~18.5 months
post-tx
Donor Fraction Estimate (DFE) 0.1% 0.1% 0.32% 0.3% 0.6%
Donor Quantity Score (DQS) 7.9 cp/mL 12.4 cp/mL 15.9 cp/mL 88.0 cp/mL 83.5 cp/mL
Biopsy diagnosis         ABMR
ProsperaTM Draw Donor Fraction Estimate (DFE) Donor Quantity Score (DQS) Biopsy diagnosis
~1 year post-tx 0.1% 7.9 cp/mL  
~13 months post-tx 0.1% 12.4 cp/mL  
~16 months post-tx 0.32% 15.9 cp/mL  
~18 months post-tx 0.3% 88.0 cp/mL  
~18.5 months post-tx 0.6% 83.5 cp/mL ABMR

Key Takeaway

Repeat testing with ProsperaTM revealed consecutive results above DQS threshold, prompting a biopsy to confirm rejection. Test with only donor fraction results may not have triggered the necessary follow-up to find this case of ABMR.

Case: Diagnosing TCMR ~9 months post-transplant due to ProsperaTM with DQS finding

Middle aged woman cartoon headshot

Patient
demographics

  • Female in mid-50s
  • High risk due to COVID-19, BK infection, DSA+, and allograft dysfunction

ProsperaTM test
summary

ProsperaTM Draw ~2 months
post-tx		 ~3 months
post-tx		 ~4 months
post-tx		 ~6 months
post-tx		 ~9 months
post-tx
Donor Fraction Estimate (DFE) 0.1% 0.1% 0.07% 0.08% 0.43%
Donor Quantity Score (DQS) 6.0 11.3 8.7 6.0 92.6
Biopsy diagnosis         TCMR
ProsperaTM Draw Donor Fraction Estimate (DFE) Donor Quantity Score (DQS) Biopsy diagnosis
~2 months post-tx 0.1% 6.0  
~3 months post-tx 0.1% 11.3  
~4 months post-tx 0.07% 8.7  
~6 months post-tx 0.08% 6.0  
~9 months post-tx 0.43% 92.6 TCMR

Key Takeaway

ProsperaTM with DQS flagged an otherwise undetected issue that led to diagnosis of TCMR. The donor fraction estimate was elevated, yet was still far below the threshold for rejection and likely would not have led to follow-up as quickly.

Case: Diagnosing TCMR at first year post-transplant due to ProsperaTM with DQS finding

Old man cartoon headshot

Patient
demographics

  • Male in mid-50s
  • Long time on dialysis pre-transplant and type II diabetes

ProsperaTM test
summary

ProsperaTM Draw ~1.5 months
post-tx		 ~3 months
post-tx		 ~3.5 months
post-tx		 ~6 months
post-tx		 ~1 year
post-tx
Donor Fraction Estimate (DFE) 0.12% 0.14% 0.1% 0.1% 0.48%
Donor Quantity Score (DQS) 9.5 8.5 6.2 5.0 95.0
Biopsy diagnosis         TCMR
ProsperaTM Draw Donor Fraction Estimate (DFE) Donor Quantity Score (DQS) Biopsy diagnosis
~1.5 months post-tx 0.12% 9.5  
~3 months post-tx 0.14% 8.5  
~3.5 months post-tx 0.1% 6.2  
~6 months post-tx 0.1% 5.0  
~1 year post-tx 0.48% 95.0 TCMR

Key Takeaway

Even with a stable serial donor fraction estimate, a significant DQS increase in the ProsperaTM result prompted diagnosis of TCMR.

De-identified real patient cases for illustrative purposes.

bp-ABMR=biopsy-proven antibody-mediated rejection; bp-TCMR= borderline T cell-mediated rejection; eGFR=epidermal growth factor receptor.

References:

  1. Bromberg JS, Bunnapradist S, Samaniego-Picota M, et al. Elevation of donor-derived cell-free DNA before biopsy-proven rejection in kidney transplant. Transplantation. 2024;108(9):1994-2004. doi:10.1097/TP.0000000000005007
  2. Sigdel TK, Archila FA, Constantin T, et al. Optimizing detection of kidney transplant injury by assessment of donor-derived cell-free DNA via massively multiplex PCR. J Clin Med. 2018;8(1):19. doi:103390/jcm8010019
  3. Halloran PF, Reeve J, Madill-Thomsen KS, et al. Combining donor-derived cell-free DNA fraction and quantity to detect kidney transplant rejection using molecular diagnoses and histology as confirmation. Transplantation. 2022;106(12):2435-2442. doi:10.1097/TP.0000000000004212
  4. Gauthier PT, Madill-Thomsen KS, Demko Z, et al. Distinct molecular processes mediate donor-derived cell-free DNA release from kidney transplants in different disease states. Transplantation. 2024;108(4):898-910. doi:10.1097/TP.0000000000004877
  5. Bunnapradist S, et al. Increases from baseline dd-cfDNA fraction are associated with acute allograft rejection in kidney transplant recipients. Poster presented at: American Transplant Congress; June 3-7, 2023; San Diego, CA.
  6. Cooper M, Chen Y-A, Barnes D, et al. Donor-derived cfDNA fraction levels in stable kidney transplant recipients in the first year after transplant. Poster presented at: American Transplant Congress; June 3-7, 2023; San Diego, CA.

Switching labs can be a challenge, but the NateraCore Concierge Startup Program made our transition to ProsperaTM seamless. Their dedicated team removed administrative burdens, ensuring our clinic could adopt a better testing protocol without disrupting patient care.

KOL Image KOL Image KOL Image

Switching labs can be a challenge, but the NateraCore Concierge Startup Program made our transition to ProsperaTM seamless. Their dedicated team removed administrative burdens, ensuring our clinic could adopt a better testing protocol without disrupting patient care.

Peter Burke, DO, MBA

Medical Director
CCHS Kidney Transplant Program

Newark, DE

NateraCore Concierge Startup Program

Finally, diagnostic integration made easy

Natera ensures a successful transition to ProsperaTM use with established support and services across industries including:

  • Customized workflow optimization
  • Simple blood draw options

Natera Core

Proven approach to simplify the startup process1

1 in 2

NIPTs ordered in the US are PanoramaTM2

1 in 3

oncologists in the US use SignateraTM2

> 60%

of US transplant centers use ProsperaTM2

NateraCore Concierge Startup Program

Take sample management workload off of your transplant coordinators through:
Natera-Managed Blood Draw Program

  • Assists with order placement in Natera’s Provider Portal and your EMR
  • Sends ProsperaTM kits and requisition forms to patient home or preferred location
  • Coordinates and schedules blood draw with your patient, including mobile phlebotomy
  • Provides tracking, status and results through Natera’s Provider Portal
  • Assigns dedicated Natera Patient Coordinator to manage process and answer questions, including billing

Get ahead of logistics through:
Clinic-Managed Blood Draw Program

  • Ships ProsperaTM test kits to lab or preferred location
  • Troubleshoots logistical or operational challenges

New clinic onboarding with a systematic approach, tailored to your clinic’s needs

Kickoff

Introductions & role clarifications

Disco­very

Initial assessment to understand your needs and identify workflow optimization opportunities

Implemen­tation

Customized workflow & set up with support from Natera Clinical Nurse Coordinator

Education, Training, & Go Live

Training and education prior to official Go Live to ensure teams are prepared

Ongoing Support

Dedicated support to ensure success

Dedicated Natera Clinical Nurse Coordinator works with your team to establish the best workflow for your team

References:

  1. Fajardo M, Thal M, Porter A, et al. Role of nurse coordinators in leveraging efficiency gains of dd-cfDNA testing in post-thoracic transplant patients: a pilot study. Poster presented at: 49th Annual Meeting of the North American Transplant Coordinators Organization (NATCO); February 25–28, 2024; San Antonio, TX.
  2. Internal data as of June 2023.

“Switching labs can be a challenge, but the NateraCore Concierge Startup Program made our transition to ProsperaTM seamless. Their dedicated team removed administrative burdens, ensuring our clinic could adopt a better testing protocol without disrupting patient care.

KOL Image KOL Image KOL Image

“Switching labs can be a challenge, but the NateraCore Concierge Startup Program made...

Explore resources available for successfully transitioning to ProsperaTM

Explore resources available for successfully transitioning to ProsperaTM

Peter Burke, DO, MBA

Medical Director
CCHS Kidney Transplant Program

Newark, DE

Unlike traditional tests that provide only a fractional measure of donor-derived cell-free DNA, ProsperaTM leverages Natera’s proprietary cell-free DNA technology to deliver a more comprehensive and precise assessment of transplant health. This gives me the information to tailor immunosuppression strategies to the unique needs of each patient.

KOL Image KOL Image KOL Image

Unlike traditional tests that provide only a fractional measure of donor-derived cell-free DNA, ProsperaTM leverages Natera’s proprietary cell-free DNA technology to deliver a more comprehensive and precise assessment of transplant health. This gives me the information to tailor immunosuppression strategies to the unique needs of each patient.

Leonardo Pozo-Garcia

Transplant Nephrologist
Arizona Kidney Disease and Hypertension Center

Tucson, AZ

The ProsperaTM test utilizing a two-threshold algorithm, combining donor fraction and donor-derived cfDNA (dd-cfDNA) quantity score (DQS), demonstrates a significant improvement in identifying active rejection compared with either variable alone1

Image illustrating the additional cases identified when utilizing donor faction and dd-cfDNA levels

Increased SensitivityProsperaTM utilizing a two-threshold algorithm detected six (6) additional cases of rejection compared to a 1% dd-cfDNA fraction alone1

Extensive history and experience with cell-free DNA (cfDNA) across industries powers new features that improve the lives of broader patient populations

ProsperaTM for Simultaneous
Pancreas Kidney

Demonstrated exceptional identification of rejection using dd-cfDNA amount — in line with ProsperaTM Kidney test performance2*

Kidney graphic

ProsperaTM Kidney
for ages 10+

Noninvasive, remote option to routinely track kidney recipients transitioning from pediatric to adult transplant care

Person graphic

ProsperaTM Heart
& ProsperaTM Lung

Single, noninvasive test that detects both AMR and ACR rejection to help optimize/reduce biopsy use

Lung and heart graphic

The highest sensitivity and specificity of dd-cfDNA level was assessed at a threshold of rejection at ≥70 cp/mL.2 The ProsperaTM Simultaneous Pancreas-Kidney Test currently utilizes ≥78 cp/mL threshold for clinical reporting based on monitoring of kidney and/or pancreas rejection. ProsperaTM cannot distinguish if a patient’s rejection risk is specifically due to the pancreas or kidney in patients with both simultaneous pancreas-kidney transplants.

dd-cfDNA fraction

Provides percent of cell-free DNA in
the recipient's blood that originates
from the allograft1,3

Vile graphic

Estimated amount of dd-cfDNA

dd-cfDNA score provides an estimate
of the amount of cfDNA in copies per
milliliters to help avoid false negative
interpretations1,3

DNA graphic

Track over time

Provides longitudinal view of donor fraction
for your ProsperaTM surveillance patients

DNA and calendar graphic
DNA and calendar graphic

Support available every step of the way

Delivery truck graphic

Rapid test results delivered within 3 days

HCP in computer graphic

Suite of concierge
services and programs

Shield graphic

Covered by Medicare & provides financial support programs

ABMR=antibody-mediated rejection; ACR=acute cellular rejection; AMR=antibody-mediated rejection; TCMR=T cell-mediated rejection.

References:

  1. Halloran PF, Reeve J, Madill-Thomsen KS, et al. Combining donor-derived cell-free DNA fraction and quantity to detect kidney transplant rejection using molecular diagnoses and histology as confirmation. Transplantation. 2022;106(12):2435-2442. doi:10.1097/TP.0000000000004212
  2. Ventura-Aguiar P, Ramirez-Bajo MJ, Rovira J, et al. Donor-derived cell-free DNA shows high sensitivity for the diagnosis of pancreas graft rejection in simultaneous pancreas-kidney transplantation. Transplantation. 2022;106(8):1690-1697. doi:10.1097/TP.0000000000004088
  3. Bunnapradist S, Homkrailas P, Ahmed E, Fehringer G, Billings PR, Tabriziani H. Using both the fraction and quantity of donor-derived cell-free DNA to detect kidney allograft rejection. J Am Soc Nephrol. 2021;32(10):2439-2441. doi:10.1681/ASN.2021050645

“Unlike traditional tests that provide only a fractional measure of donor-derived cell-free DNA, ProsperaTM leverages Natera’s proprietary cell-free DNA technology to deliver a more comprehensive and precise assessment of transplant health. This gives me the information to tailor immunosuppression strategies to the unique needs of each patient.

KOL Image KOL Image KOL Image

“Unlike traditional tests that provide only a fractional measure of donor-derived cell-free DNA...

Explore Natera’s extensive experience with cell-free DNA

Explore Natera’s extensive experience with cell-free DNA

Leonardo Pozo-Garcia

Transplant Nephrologist
Arizona Kidney Disease and Hypertension Center

Tucson, AZ

When managing my transplant patients, extending graft longevity remains a top priority. Measuring donor-derived cell-free DNA presents a compelling method for detecting active rejection and improving patient outcomes.

KOL Image KOL Image KOL Image

When managing my transplant patients, extending graft longevity remains a top priority. Measuring donor-derived cell-free DNA presents a compelling method for detecting active rejection and improving patient outcomes.

Sundus A. Lodhi, MD

Medical Director, Kidney and Pancreas Transplant, Transplant Nephrologist

Atlanta, GA

The ProsperaTM test is for clinicians treating patients across the entire transplant continuum. The goal is earlier, more accurate detection of rejection that enables treatment to promote longer graft life.

Transplant Patient Care Toolkit Transplant Patient Care Toolkit

The ProsperaTM transplant assessment evaluates the level of donor-derived cell-free DNA (dd-cfDNA) in the kidney transplant recipient’s blood, which strongly correlates with acute rejection1,3

Blood vile graphic + DNA graphic + test result graphic + DNA graphic + test result graphic Blood vile graphic + DNA graphic + test result graphic + DNA graphic + test result graphic

ProsperaTM With Donor Quantity Score (DQS)

Natera’s ProsperaTM transplant assessment test is powered by proprietary cfDNA technology, optimized from our extensive history and experience with cfDNA across women’s health, oncology, and organ transplantation. Traditional dd-cfDNA tests only report the fraction of cfDNA from the transplanted kidney to identify potential active rejection.

Human graphic Human graphic Human graphic

Only ProsperaTM with DQS provides dd-cfDNA fraction and the amount of dd-cfDNA (DQS) for improved sensitivity on every report.

Explore the powerful clinical performance of the ProsperaTM test shown in the Trifecta study

The Trifecta study represents the largest multisite, prospective, fully biopsy-matched cohort with dd-cfDNA analysis for kidney transplant recipients conducted to date.

25US and International sites

367Biopsy-matched samples from adult kidney transplant recipients

125Histology-confirmed rejections in an indication biopsy cohort

Kidney graphic

One test is all it takes1,3-5

Identify antibody-mediated rejection (ABMR), T cell-mediated rejection (TCMR) and mixed rejection, providing a comprehensive view of a patient’s rejection status1,3-5

Rejection Graph
Shield with check-mark graphic

Greater assurance for appropriate referral and biopsy decisions3

Confidently identify patients in rejection
and non-rejection
to potentially avoid unnecessary biopsies

Image illustrating the confident identification of patients in rejection and non-rejection, helping to potentially avoid unnecessary biopsies
DNA graphic

Consistently superior compared to MMDx and histology3

The high Area Under the Curve (AUC) shows the exceptional ability of ProsperaTM to discriminate between rejection and non-rejection

Image illustrating the high Area Under the Curve (AUC) shows the exceptional ability of ProsperaTM to discriminate between rejection and non-rejection

References:

  1. Sigdel TK, Archila FA, Constantin T, et al. Optimizing detection of kidney transplant injury by assessment of donor-derived cell-free DNA via massively multiplex PCR. J Clin Med. 2018;8(1):19. doi:103390/jcm8010019
  2. Cooper J, Gralla J, Cagle L. Inferior kidney allograft outcomes in patients with de novo donor-specific antibodies are due to acute rejection episodes. Transplantation. 2001;91:1103-1109.
  3. Halloran PF, Reeve J, Madill-Thomsen KS, et al. Combining donor-derived cell-free DNA fraction and quantity to detect kidney transplant rejection using molecular diagnoses and histology as confirmation. Transplantation. 2022;106(12):2435-2442. doi:10.1097/TP.0000000000004212
  4. Bunnapradist S, Homkrailas P, Ahmed E, Fehringer G, Billings PR, Tabriziani H. Using both the fraction and quantity of donor-derived cell-free DNA to detect kidney allograft rejection. J Am Soc Nephrol. 2021;32(10):2439-2441. doi:10.1681/ASN.2021050645
  5. Lum EL, Nieves-Borrero K, Homkrailas P, Lee S, Danovitch G, Bunnapradist S. Single center experience comparing two clinically available donor derived cell free DNA tests and review of literature. Transplant Rep. 2021;6(3):100079. doi:10.1016/j.tpr.2021.100079

“When managing my transplant patients, extending graft longevity remains a top priority. Measuring donor-derived cell-free DNA presents a compelling method for detecting active rejection and improving patient outcomes.

KOL Image KOL Image KOL Image

“When managing my transplant patients, extending graft longevity remains a top priority...

See how ProsperaTM works and the data behind it

See how ProsperaTM works and the data behind it

Sundus A. Lodhi, MD

Medical Director, Kidney and Pancreas Transplant, Transplant Nephrologist

Atlanta, GA