Dr Michelle Kittleson shares noninvasive monitoring strategies for heart transplant rejection.
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There are other reasons to investigate noninvasive strategies for rejection surveillance. Given the low incidence of asymptomatic rejection, a sensitive surveillance strategy with a high negative predictive value may minimize the number of biopsies needed. A contemporary surveillance strategy should also permit early detection of rejection as compared with the histopathologic changes that represent more advanced stages of immune activation.
There are several currently available commercial assays, one of which is used routinely in heart transplant recipients for rejection surveillance, the AlloSure assay. The current noninvasive options for rejection surveillance include the AlloMap gene expression profiling assay and the AlloSure donor-derived cell-free DNA assay combined in theabout who, when, and how.
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