Sean Agbor-Enoh et al have devised a blood test that could make it possible for doctors to detect and prevent or slow down acute heart transplant rejection that may occur in the early months after a patient has received a donor heart. The test, named donor-derived cell-free DNA test (ddcfDNA), tracks DNA markers from the organ donor that appear in the blood of the transplant recipient. The researchers collected blood samples from 171 people who had recently undergone heart transplantation. The team collected plasma samples simultaneously with endomyocardial biopsy (EMBx) for ddcfDNA measurement by shotgun sequencing. The sampling included nearly 2,000 cell-free DNA measurements. The researchers monitored the patients for signs of acute rejection for nearly 18 months using both traditional endomyocardial biopsy and the new blood test. The researchers found that the blood test performed better in their study than tissue biopsy, detecting higher amounts of rejection markers of acute cellular rejection (ACR) and antibody-mediated rejection (AMR). They estimated that the test could eliminate up to 80% of invasive heart tissue biopsies currently used to detect rejection. The new blood test may be able to detect rejection as early as 28 days after heart transplantation and at least three months before the rejection is detectable using heart tissue biopsy.
Source: Circulation| 13 Jan 2021 https://doi.org/10.1161/CIRCULATIONAHA.120.049098