Post-transplant ischemic injury is associated with up-regulated AlloMap gene expression.
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.
Yamani
M H
MH
Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA. yamanim@ccf.org
Taylor
D O
DO
Haire
C
C
Smedira
N
N
Starling
R C
RC
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
D007519:Isoantigens