title: Post-transplant ischemic injury is associated with up-regulated AlloMap gene expression.
abstract: BACKGROUND
  The AlloMap gene expression test is used for the non-invasive detection of rejection. However, the impact of early post-transplant ischemic injury on subsequent AlloMap gene expression analysis has not been evaluated before.
  
  
  METHODS
  Sixty seven heart transplant recipients, mean age 53 years, were evaluated at a mean 34 months post-transplant. AlloMap score was determined on the same day of heart biopsies. Nineteen patients had evidence of early post-transplant ischemic injury (Injury group). These were compared with the remaining 48 patients, Control group.
  
  
  RESULTS
  Using multiple regression model with a backward selection method, post-transplant ischemic injury was found to be associated with significant increased AlloMap score compared with controls (31.5 +/- 4.6 vs. 26 +/- 6.2, p < 0.001). The Injury group had increased transplant vasculopathy (KM 5-year freedom from vasculopathy: 34% vs. 52%, p = 0.015), than Controls.
  
  
  CONCLUSIONS
  Post-transplant ischemic injury is associated with up-regulated AlloMap gene expression, and hence, may provide another explanation for a high score in the absence of rejection.
authors.affiliation: Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA. yamanim@ccf.org
authors.forename: M H
authors.initials: MH
authors.lastname: Yamani
authors.forename: D O
authors.initials: DO
authors.lastname: Taylor
authors.forename: C
authors.initials: C
authors.lastname: Haire
authors.forename: N
authors.initials: N
authors.lastname: Smedira
authors.forename: R C
authors.initials: RC
authors.lastname: Starling
mesh_terms: D000328:Adult; D001706:Biopsy; D017023:Coronary Angiography; D005260:Female; D015870:Gene Expression; D020869:Gene Expression Profiling; D006084:Graft Rejection / Q000473:pathology; D016027:Heart Transplantation; D006801:Humans; D007519:Isoantigens / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000235:genetics*; D015428:Myocardial Reperfusion Injury / Q000235:genetics*; D011183:Postoperative Complications; D013318:Stroke Volume; D015854:Up-Regulation
chemical_list: D007519:Isoantigens