Work

Gene expression profiling does not predict long-term risk of malignancy in heart transplant recipients

Year: 2026

Type: article

Abstract: Introduction Heart transplant (HT) recipients require immunosuppression for the prevention of graft rejection but remain at risk for malignancy. AlloMap (CareDx ®) is a gene expression profiling (GEP) method that can act as a non-invasive alternative to endomyocardial biopsy for surveillance of graft rejection. While higher activation scores are suggestive of rejection, it is unknown if lower scores are correlated with higher risk of malignancy. The aim of this study is to identify the association between AlloMap score and development of future malignancy. Methods We conducted a multicenter, retrospective, observational cohort study that included 444 adult HT recipients between 2010-2021 who were evaluated with the AlloMap assay. Median AlloMap score was calculated from available scores in the first year after HT. The primary outcome of interest was development of any de novo malignancy. Multivariable analyses were conducted using competing risk and repeated measures models to assess the impact of AlloMap on the primary outcome. Results No statistically significant association between AlloMap score and the cumulative incidence of de novo malignancy was observed for our primary analysis utilizing AlloMaps collected in the first year (p=0.211) or the first two years (p=0.485) after HT. AlloMap scores were also not predictive of longer-term all-cause mortality. Conclusion AlloMap scores in the first one or two years after HT were not predictive of long-term malignancy risk in our multicenter study.

Source: JHLT Open

DOI: 10.1016/j.jhlto.2026.100500