Natera and Eledon Pharmaceuticals partnered to incorporate Natera’s Prospera donor-derived cell-free DNA test into a Phase 3 kidney transplant study evaluating Eledon’s investigational anti-CD40L antibody tegoprubart. Prospera will act as the exclusive longitudinal dd-cfDNA monitoring assay across a global trial expected to enroll about 600 transplant recipients. The companies said Prospera will be used via a two-threshold algorithm that combines relative dd-cfDNA fraction and calculated total dd-cfDNA to track allograft injury dynamics. This is the first time Prospera will be used as a routine surveillance tool in a large-scale therapeutic trial in transplantation, Natera said. Tegoprubart is intended to reduce rejection risk and the toxicity burden of long-term immunosuppression. By embedding a noninvasive biomarker strategy into trial design, the partnership aims to strengthen decision-making around when graft stress is occurring and how it correlates with efficacy. For the transplant market, the move is another step toward replacing or augmenting biopsy-dependent monitoring with molecular readouts that could enable earlier intervention and more consistent data capture across centers.