Effect of Gene Expression Profiling Surveillance Compared With Endomyocardial Biopsy On Tricuspid Regurgitation in Patients with Heart Transplant.

OBJECTIVES

Gene expression profiling is an emerging noninvasive method for rejection surveillance in heart transplants. Tricuspid regurgitation prevalence increases over time after heart transplant, and many prior studies have implicated invasive endomyocardial biopsy. The relationship between the use of gene expression profiling (AlloMap molecular expression test; CareDx ) versus endomyocardial biopsy with regard to prevalence of tricuspid damage has never been studied.

MATERIALS AND

METHODS

Among 158 heart transplant patients with history of gene expression profiling and mean follow -up duration of 10.3 years that we reviewed, 114 patients were included in this study. Patients were divided into 4 groups based on mean endomyocardial biopsy and mean gene expression profiling sampling times. Tricuspid regurgitation grade change was compared between the group with less gene expression profiling and more endomyocardial biopsy versus the group with more gene expression profiling and less endomyocardial biopsy.

RESULTS

Results from this single -center study showed that no statistically significant difference in tricuspid regurgitation for cardiac transplant patients who were monitored for rejection by endomyocardial biopsy versus gene expression profiling.

CONCLUSIONS

Preference of gene expression profiling instead of endomyocardial biopsy for rejection surveillance does not have a significant effect on tricuspid valve regurgitation.