Sparing the Prod: Providing an alternative to endomyocardial biopsies with non-invasive surveillance after heart transplantation during COVID-19

BACKGROUND: The COVID-19 pandemic has reduced access to endomyocardial biopsy (EMBx) rejection surveillance in heart transplant (HT) recipients. This is the first Canadian study to assess the role for non-invasive rejection surveillance in personalizing titration of immunosuppression (IS) and patient satisfaction post-HT.

METHODS: In this mixed methods prospective cohort study, adult HT recipients more than six months from HT had their routine EMBx replaced by non-invasive rejection surveillance with gene expression profiling (GEP) and donor-derived cell-free DNA (dd-cfDNA). Demographics, outcomes of non-invasive surveillance score, hospital admissions, patient satisfaction, and health status on Medical Outcomes Study 12-item Short Form Health Survey (SF-12) were collected and analyzed using t-tests and chi-squared tests. Thematic qualitative analysis was performed for open-ended responses. Read more.