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Updated: Jun 10, 2026
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In Vitro and In Vivo Assessment of T, B and Myeloid Cells Suppressive Activity and Humoral Responses from Transplant Recipients
Published on: August 12, 2017
Surrogate markers of rejection.
Bethany A Austin1, David O Taylor
1Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
Current Opinion in Organ Transplantation
|July 24, 2010
Summary
Noninvasive methods for monitoring heart transplant rejection are still being developed. While gene expression profiling shows promise as an adjunctive tool, endomyocardial biopsy remains the current standard for surveillance.
Area of Science:
- Cardiology
- Transplantation Medicine
- Immunology
Background:
- Endomyocardial biopsy (EMB) is the current gold standard for monitoring heart transplant rejection.
- There is a need for noninvasive alternatives to EMB due to its risks and limitations.
Purpose of the Study:
- To review the clinical utility of available and emerging noninvasive surrogate markers for monitoring heart transplant rejection.
- To assess the potential of these markers to replace or supplement EMB.
Main Methods:
- Systematic review of clinical studies evaluating noninvasive markers for heart transplant rejection.
- Analysis of imaging modalities and peripheral biomarkers.
- Evaluation of gene expression profile analysis.
Main Results:
- Current imaging and peripheral biomarkers lack the accuracy to replace EMB.
- Gene expression profile analysis is a promising complementary technology.
- Insufficient clinical trial data exists to substitute EMB with gene expression profiling for all patients.
Conclusions:
- EMB remains the gold standard for routine surveillance of orthotopic heart transplantation rejection.
- Gene expression profile analysis can serve as a useful adjunctive tool.
- Gene expression profiling may reduce the frequency of EMB in low-risk patients.
