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Blood Test can Detect Heart-Transplant Rejection Faster than a Biopsy

Update Date: Jun 18, 2014 02:11 PM EDT

According to researchers from Stanford University, a simple blood test can be accurate in detecting whether or not a patient will reject a heart transplant before undergoing the invasive procedure. The researchers reported that the test is noninvasive and faster than a biopsy.

"This test appears to be safer, cheaper and more accurate than a heart biopsy, which is the current gold standard to detect and monitor heart-transplant rejection," said Stephen Quake, PhD, professor of bioengineering and of applied physics. "We believe it's likely to be very useful in the clinic."

The test, which is called a cell-free DNA test, works by monitoring the levels of the donor's DNA in the heart transplant patient's blood. By detecting these levels, doctors can treat patients with anti-rejection medications if needed. Currently, there is one other blood test used to detect rejection called AlloMap. AlloMap works by analyzing the patient's blood for the expression of genes linked to rejection. The researchers stated that that their cell-free DNA test was more effective than AlloMap.

"We've found that this cell-free DNA assay is a very accurate way to diagnose acute rejection, sometimes weeks to months before a biopsy picks up any signs," senior author of the study, Kiran Khush, MD, assistant professor of medicine, said according to the press release. "This earlier detection may prevent irreversible damage to the transplanted organ."

The study involved 65 children and adult patients with a total of 565 samples. The researchers had followed the statuses of these patients before and after their transplants. Throughout the study, the team had compared the results of using the cell-free DNA test to biopsies. They concluded that the test was effective in detecting two main types of rejection in 24 of the patients. The test also identified signs of rejection up to five months before the biopsies yielded any troubling results.

"This test has the potential to revolutionize the care of our patients," said Khush. "It may also allow us to conduct several diagnostic tests simultaneously. For example, we could also look for microbial sequences in the blood sample to rule out infection or other complications sometimes experienced by transplant recipients. It could allow us to determine whether shortness of breath experienced by a patient is due to an infection or the start of a rejection episode. It could be a one-stop shop for multiple potential problems."

The study was published in Science Translational Medicine.

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