Gene-Expression Profiling to Assess Rejection After Cardiac Transplantation

To monitor for early signs of organ rejection, heart transplant recipients currently undergo periodic biopsies. According to some reports, gene-expression profiling of peripheral-blood specimens can convey the same information as endomyocardial biopsy. To test this approach, investigators at 13 U.S. centers studied 602 patients who had undergone cardiac transplantation between 6 months and 5 years previously and were at low risk for rejection. Participants were randomized to surveillance via either gene-expression profiling or routine endomyocardial biopsy. Biopsy was performed after clinical or echocardiographic evidence of graft dysfunction in any patient or after a prespecified abnormal gene-expression profiling score in the gene-profili…