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Gene expression test reduces need for invasive heart muscle biopsy
Date:4/26/2010

ly assigned 602 patients who were six months to five years since their heart transplantation to undergo rejection monitoring using either gene-expression profiling or routine endomyocardial biopsy, in addition to clinical and echocardiographic assessment of graft function. They compared the two groups for a composite primary outcome of rejection with heart function compromise, graft dysfunction due to other causes, death, or retransplantation. They found that during a median follow-up of 19 months, patients monitored with gene-expression profiling, as compared with those who underwent routine biopsies, had similar two-year cumulative rates of the composite primary outcome. The two-year rates of all-cause mortality were also similar in the gene-expression profiling and biopsy arms. Patients in the gene-expression profiling group underwent one-sixth the number of biopsies per person-year of follow-up compared with patients in the biopsy group. (For those in the gene expression test group, biopsies were performed when the test indicated an elevated risk for rejection, or if there were other clinical indications of rejection via cardiogram or symptoms.)

The new findings build on development and validation the Allomap blood test published in a research study called CARGO (Cardiac Allograft Rejection Gene Expression Observational Study) in 2005 (Deng et al, American Journal of Transplantation). The CARGO-study, whose lead author was Dr. Deng, showed that the blood test could detect whether a chronic heart transplant patient is rejecting his heart, and reduce the need for invasive heart-muscle biopsies.

Beyond their instrumental role in the development of the original AlloMap molecular test and now its safe implementation into routine patient care, Dr. Deng's team has also spearheaded research into how this test works, specifically how the biological activity of white blood cell genes is linked to rejection in the transplanted heart. They found that the
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Contact: Jennifer Homa
jeh9057@nyp.org
212-305-5587
New York- Presbyterian Hospital/Columbia University Medical Center
Source:Eurekalert

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