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Are Changes in Clinical Practice Reflected in Gene Expression Profiling Scores After Heart Transplantation?

T. Wolf-Doty1, K. K. Khush2, J. J. Teuteberg2

1CareDx, Brisbane, CA, 2Stanford University, Stanford, CA

Meeting: 2022 American Transplant Congress

Abstract number: 1124

Keywords: Allorecognition

Topic: Clinical Science » Heart » 63 - Heart and VADs: All Topics

Session Information

Session Name: Heart and VADs: All Topics

Session Type: Poster Abstract

Date: Sunday, June 5, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

Session Information

Session Name: Poster Chat: Heart and Lung

Session Type: Poster Chat

Date: Tuesday, June 7, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Hall C

*Purpose: AlloMap (AM) is a peripheral blood gene expression profiling (GEP) tool used for the assessment of acute cellular rejection in heart transplant recipients (HT). GEP is clinically indicated with steroid use <20mg because of the incorporation of 3 steroid sensitive genes in the algorithm. The objective of this study was to characterize the changing patterns of early GEP scores to ascertain whether differences in steroid use may be a factor.

*Methods: All clinical GEP test scores (sent to CareDx) between January 2006 and November 2021 were reviewed. Results were grouped into 3-time periods; 2006-2010, 2011-2015 and 2016-2021. Means were considered against months post-transplant (MPT) and assessed using student’s t-test. Prednisone dose was described from the SHORE registry at >2 MPT, 2-3 MPT, 3-6 MPT, >6 MPT to assess current steroid clinical practice.

*Results: 197,658 GEP results were examined with a median GEP score of 30.77. Mean 2-month GEP score was 21 in 2006-2010 compared to 26 in 2016-2021 (p<0.0001) and the mean 6-month GEP score was 27 in 2006-2010 compared to 29 in 2016-2021 (p<0.0001). Median steroid dose was: 20mg (>2 MPT; n=835), 12.5mg (2-3 MPT; n=1289), 7.5mg (3-6 MPT; n=2513) and 2mg (>6 MPT; n=2668).

*Conclusions: Since 2006, there has been a progressive increase in the AM scores across at 2- and 6-months post-HT. These differences were mirrored by decreasing steroid doses across these same time periods. Interpretation of changes in AM scores, particularly changes early post-HT, should reflect this change in clinical practice.

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To cite this abstract in AMA style:

Wolf-Doty T, Khush KK, Teuteberg JJ. Are Changes in Clinical Practice Reflected in Gene Expression Profiling Scores After Heart Transplantation? [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/are-changes-in-clinical-practice-reflected-in-gene-expression-profiling-scores-after-heart-transplantation/. Accessed May 9, 2025.

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