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Updated: Apr 15, 2026

Single Cell Transcriptional Profiling of Adult Mouse Cardiomyocytes

Single Cell Transcriptional Profiling of Adult Mouse Cardiomyocytes

Published on: December 28, 2011

Gene expression profiling to study racial differences after heart transplantation.

Kiran K Khush¹, Michael X Pham¹, Jeffrey J Teuteberg²

¹Stanford University School of Medicine, Stanford, California.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation

|April 5, 2015

Summary

African Americans and other non-Caucasian heart transplant recipients face a 2.5-3 times higher risk of adverse outcomes. This disparity may stem from biological factors affecting the alloimmune response to immunosuppressants like tacrolimus.

Keywords:

acute rejection calcineurin inhibitor gene expression profile score heart transplantation mortality race

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Area of Science:

Immunology
Transplantation Medicine
Genomics

Background:

Increased mortality post-heart transplantation in non-Caucasian populations is not well understood.
Biologic factors are hypothesized to drive the higher risk of adverse events.
The Invasive Monitoring Attenuation through Gene Expression (IMAGE) study investigated racial disparities in heart transplant outcomes.

Purpose of the Study:

To determine if the rate of acute rejection, graft dysfunction, death, or retransplantation varies by race.
To assess the influence of calcineurin inhibitor (CNI) levels and gene expression profile (GEP) scores on racial differences in outcomes.
To explore the biological basis of observed racial disparities in heart transplant outcomes.

Main Methods:

Compared the incidence of primary adverse events across racial groups, stratified by time post-transplant.
Utilized logistic regression to calculate relative risks between racial groups.
Employed linear modeling to analyze the relationship between race, CNI levels, and GEP scores.

Main Results:

The primary endpoint occurred in 18.3% of African Americans, 22.2% of other non-Caucasians, and 8.5% of Caucasians (p < 0.001).
Tacrolimus trough levels were similar across races, but non-Caucasians had higher GEP scores.
African American recipients showed a unique decrease in FLT3 gene expression with higher tacrolimus levels.

Conclusions:

Non-Caucasian heart transplant recipients had a 2.5-3 times higher likelihood of adverse outcomes compared to Caucasians.
The increased risk may be linked to the biology of the alloimmune response.
Similar tacrolimus levels may be less effective in inhibiting the alloimmune response in minority racial groups.