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The molecular refinement of the diagnosis of heart allograft rejection based on whole-transcriptome analyses faces several hurdles that greatly limit its widespread clinical application. The targeted Banff Human Organ Transplant gene panel (B-HOT, including 770 genes of interest) has been developed to facilitate reproducible and cost-effective gene expression analysis of solid organ allografts. We aimed to determine the ability of this targeted panel to capture the antibody-mediated rejection (AMR) molecular profile using whole-transcriptome data from 137 heart allograft biopsies (71 biopsies reflecting the entire landscape of histologic AMR, 66 non-AMR control biopsies including cellular rejection and non-rejection cases). Differential gene expression, pathway and network analyses demonstrated that the B-HOT panel captured biologically and clinically relevant genes (IFNG-inducible, NK-cells, injury, monocytes-macrophage, B-cell-related genes), pathways (interleukin and interferon signaling, neutrophil degranulation, immunoregulatory interactions, endothelial activation) and networks reflecting the pathophysiological mechanisms underlying the AMR process previously identified in whole-transcriptome analysis. Our findings support the potential clinical use of the B-HOT-gene panel as a reliable proxy to whole-transcriptome analysis for the gene expression profiling of cardiac allograft rejection.
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http://dx.doi.org/10.3389/ti.2023.11710 | DOI Listing |
Multimed Man Cardiothorac Surg
September 2025
Department of Cardiovascular Surgery, Marmara University Pendik Research and Training Hospital, Istanbul, Turkey.
Complete detachment of the aortic root following a Bentall procedure is an exceptionally rare complication. The vast majority of reported cases are secondary to prosthetic valve endocarditis or underlying vasculitis. Currently, the most reliable treatment for aortic root dehiscence-particularly in the context of prosthetic valve endocarditis-is repeat root replacement, typically via a second Bentall procedure or with the use of a homograft or allograft.
View Article and Find Full Text PDFClin Transplant
September 2025
Cedars-Sinai Smidt Heart Institute, Los Angeles, California, USA.
Background: Severe left ventricular/biventricular primary graft dysfunction (PGD-LV) continues to be a major contributor to 30-day mortality post-heart transplantation (HTx). In patients with severe PGD-LV, two distinctive presentation phenotypes are encountered: an "immediate PGD" (IP), where patients fail to wean from cardiopulmonary bypass (CPB), or a "delayed PGD" (DP) following successful weaning from CPB and/or transfer from the operating room. Data on these phenotypes' incidence, associated characteristics, and outcomes remain limited.
View Article and Find Full Text PDFFront Transplant
August 2025
Department of Cardiovascular Disease, Inova Schar Heart and Vascular, Falls Church, VA, United States.
Despite significant advances in organ preservation, surgical techniques, and immunosuppressive regimens, rejection continues to pose a major challenge in the care of heart transplant patients. Endomyocardial biopsy (EMB) remains the gold standard test for surveillance and diagnosis of rejection, but is limited by its invasiveness, interobserver variability, procedural risk, and cost thus prompting the widespread use of non-invasive biomarkers such as donor-derived cell-free DNA (dd-cfDNA). Due to its high negative predictive value, dd-cfDNA is often routinely used for surveillance of asymptomatic patients.
View Article and Find Full Text PDFEur Heart J Case Rep
September 2025
Department of Cardiology, Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, Av. Prof. Dr. Reinaldo dos Santos, 2790-134 Carnaxide, Portugal.
Background: Acute cardiac allograft rejection and cardiac allograft vasculopathy are among the most common and dreaded complications occurring after successful heart transplantation and mandate lifelong monitoring. Non-invasive cardiac imaging with cardiac computed tomography (CCT) and cardiovascular magnetic resonance (CMR) has the potential to reduce the number of invasive exams needed with patient and economic benefits. We present our experience with these imaging techniques in the care of heart transplant recipients.
View Article and Find Full Text PDFJ Card Fail
August 2025
Center for Advanced Heart Disease, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Electronic address:
Heart transplantation stands at the threshold of a new era shaped by transformative advances across the clinical and scientific continuum. This contemporary review highlights developments with the greatest potential to shift practice and improve patient outcomes. First, evolving strategies in organ preservation and transport- such as ex vivo perfusion and normothermic techniques- are expanding geographic boundaries and optimizing donor heart utilization.
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