Document Detail


Gene expression profiling for monitoring graft rejection in heart transplant recipients.
MedLine Citation:
PMID:  19715886     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Heart transplantation is a life-prolonging therapy for many patients with stage D heart failure and other forms of advanced heart disease. However, graft rejection and/or immunosuppression-related side effects are major causes of morbidity and death among heart transplant patients. Graft rejection monitoring remains a challenge. It would be desirable to be able to detect rejection early enough and specifically enough to prevent allograft dysfunction without unnecessary overimmunosuppression. Hitherto, the main technique employed in monitoring the rejection status of a transplanted heart has been endomyocardial biopsy (EMB), which allows rejection to be screened for and monitored on the basis of the extent and distribution of lymphocytic infiltrates and associated myocardial damage. However, EMB has significant limitations: it is invasive, its sensitivity is limited by sampling efficacy, and it suffers from considerable between-observer variability. Although many noninvasive techniques have been investigated, none so far has proved able to match the performance of EMB. Currently, a multiparametric approach is employed that comprises clinical examination for signs or symptoms of heart failure, EMBs, drug level monitoring, allograft function tests (mainly echocardiographic studies), and screening for allograft vasculopathy. Gene expression profiling may be a promising tool for this purpose.
Authors:
M G Crespo-Leiro; M J Paniagua-Mart??n; M Hermida-Prieto; A Castro-Beiras
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  41     ISSN:  1873-2623     ISO Abbreviation:  Transplant. Proc.     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-08-31     Completed Date:  2010-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2240-3     Citation Subset:  IM    
Affiliation:
Unidad de Insuficiencia Card??aca y Trasplante Cardiaco, Hospital Universitario A Coru??a, La Coru??a, Spain. Marisa.Crespo.Leiro@sergas.es
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MeSH Terms
Descriptor/Qualifier:
Gene Expression Profiling / methods*
Graft Rejection / genetics*
Heart Failure / classification,  genetics*,  surgery*
Heart Transplantation / immunology*
Humans
Immunosuppression / adverse effects
Monitoring, Physiologic / methods
Patient Selection

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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