Markers of Immune Function in Heart Transplantation: Implications for Immunosuppression and Screening for Rejection

David X. Zhuo, Katie Ginder, E. Ashley Hardin

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: Recent developments in high-throughput DNA and RNA sequencing technologies have facilitated the development of noninvasive assays to monitor heart transplant rejection. In this review, we summarize existing assays employed for the surveillance of allograft rejection, as well as promising future directions for such tests in the molecular biology field. Recent Findings: The AlloMap genome expression profiling assay remains the only noninvasive test for rejection surveillance and is incorporated into the International Society of Heart and Lung Transplantation guidelines. Other efforts have focused on messenger RNA (mRNA), microRNA (miRNA), and donor-derived cell-free DNA (dd-cfDNA) as potential viable biomarkers. Mitochondrial pathways in allograft necroptosis and inflammation signaling may represent a novel direction for future research endeavors. Summary: Although endomyocardial biopsy remains the gold standard, several converging areas of molecular biology could soon yield successful alternative methods of heart transplant rejection monitoring, with the distinct advantage of avoiding procedural complications.

Original languageEnglish (US)
Pages (from-to)33-40
Number of pages8
JournalCurrent heart failure reports
Volume18
Issue number2
DOIs
StatePublished - Apr 2021

Keywords

  • Assays
  • Biomarkers
  • Heart transplant rejection
  • Molecular biology
  • Noninvasive
  • Surveillance

ASJC Scopus subject areas

  • Emergency Medicine
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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