Purpose: Patients of African descent have been reported to have less favorable outcomes after heart transplantation than patients of European descent. However, the impact of race on outcomes in patients who are followed clinically with gene expression profiling (GEP) has not been well described.

Methods: Heart transplant patients from the 31 transplant centers in Outcomes AlloMap Registry (OAR) were studied. We compared the time of first visit using gene expression profiling (GEP) as the primary surveillance method, panel reactive antibodies (PRA) and pre-transplantation mechanical circulatory support (MCS), and allograft rejections in patients of African descent and of European descent. GEP scores (AlloMap) were analyzed upon first and subsequent post-transplantation visits.

Results: Of the 1049 patients, 760 are of European descent (ED) and 195 are of African descent (AD). At baseline there was no significant difference in PRA 6% v 7%, p=0.42 or use of MCS 53% v 57%, p=0.32 for ED and AD, respectively. There was also no difference between ED and AD in the mean time post-transplant the patients were enrolled (12.9 v 10.5 months, p=0.16). GEP scores are comparable across groups. GEP scores show equivalence between European descent and African American patients in both first visits (mean 26.8 for Caucasian, 27.4 for African American; p-value 0.31 between the two groups) and across all post-transplantation visits to date (p-value 0.13). 715 patients had 1983 visits of where biopsy results are available, there were fewer Grade ≥2R rejection events in AD compared to ED 2.26% and 6.13%, respectively, but it did not reach statistical significance, p-value 0.12.

Conclusions: Patients of African descent had similar application of GEP surveillance and were not different from patients of European descent in the risk factors for rejection and outcomes. Further, the GEP scores for African descent patients were comparable to those for European patients. For those who are candidates for surveillance with GEP, race of the patient does not appear to have an impact on outcomes.

CITATION INFORMATION: Teuteberg J, Shullo M, Rinde-Hoffman D, Wigger M, Wang Y, Wolf T, Arnold P, Sninsky J, Berman P. Routine Surveillance of Heart Transplant Recipients with Gene Expression Profiling: Lack of an Impact of Race on Outcomes. Am J Transplant. 2017;17 (suppl 3).

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