title: Biomarkers of acute rejection following cardiac transplantation.
abstract: Cardiac transplantation can be a life-saving treatment for selected patients with heart failure. However, despite advances in immunosuppressive therapy, acute allograft rejection remains a significant cause of morbidity and mortality. The current 'gold standard' for rejection surveillance is endomyocardial biopsy, which aims to identify episodes of rejection prior to development of clinical manifestations. This is an invasive technique with a risk of false-positive and false-negative results. Consequently, a wide variety of noninvasive alternatives have been investigated for their potential role as biomarkers of rejection. This article reviews the evidence behind proposed alternatives such as imaging techniques, electrophysiological parameters and peripheral blood markers, and highlights the potential future role for biomarkers in cardiac transplantation as an adjunct to biopsy.
authors.affiliation: Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Clydebank, UK.
authors.forename: Jenna F
authors.initials: JF
authors.lastname: McMinn
authors.forename: Ninian N
authors.initials: NN
authors.lastname: Lang
authors.forename: Allan
authors.initials: A
authors.lastname: McPhadden
authors.forename: John R
authors.initials: JR
authors.lastname: Payne
authors.forename: Mark C
authors.initials: MC
authors.lastname: Petrie
authors.forename: Roy S
authors.initials: RS
authors.lastname: Gardner
mesh_terms: D015415:Biomarkers / Q000097:blood; D006084:Graft Rejection / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D016027:Heart Transplantation; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain
keywords: BNP; biomarkers; cardiac transplantation; endomyocardial biopsy; prognosis; rejection