Diagnostic value of serum miR-144-3p for the detection of acute cellular rejection in heart transplant patients

Pérez-Carrillo, Lorena; Sánchez‐Lázaro, Ignacio; Triviño, Juan Carlos; Feijóo‐Bandín, Sandra; Lago, Francisca; González-Juanatey, José Ramón; Martínez‐Dolz, Luis; Portolés, Manuel; Tarazón, Estefanía; Roselló‐Lletí, Esther

doi:10.1016/j.healun.2021.10.004

Cited by 15 publications

(12 citation statements)

References 36 publications

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“… 34 More recent advances have demonstrated the effectiveness of serum microRNAs (miRNA) to effectively detect allograft rejection among heart transplant recipients with validation AUC of 0.80 for detection of ≥Grade 2R ACR using a single miRNA, albeit based on a small sample size (212 serum samples paired with EMB results). 35 A prior study had demonstrated that four separate miRNAs were able to detect all forms of cardiac allograft rejection (ACR + AMR) with AUC values ranging from 0.87 to 0.98 in an external validation sample of 53 heart transplant recipients. 36 …”

Section: Discussionmentioning

confidence: 99%

Non-invasive detection of cardiac allograft rejection among heart transplant recipients using an electrocardiogram based deep learning model

Adedinsewo

Hardway

Morales-Lara

et al. 2023

European Heart Journal - Digital Health

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Background and aims Current non-invasive screening methods for cardiac allograft rejection have shown limited discrimination and are yet to be broadly integrated into heart transplant care. Given electrocardiogram (ECG) changes have been reported with severe cardiac allograft rejection, this study aimed to develop a deep learning model, a form of artificial intelligence, to detect allograft rejection using the 12-lead ECG (AI-ECG). Methods and Results Heart transplant recipients were identified across three Mayo Clinic sites between 1998 and 2021. Twelve-lead digital ECG data and endomyocardial biopsy results were extracted from medical records. Allograft rejection was defined as moderate or severe acute cellular rejection (ACR) based on International Society for Heart and Lung Transplantation guidelines. The extracted data (7,590 unique ECG-biopsy pairs, belonging to 1,427 patients) was partitioned into training (80%), validation (10%), and test sets (10%) such that each patient was included in only one partition. Model performance metrics were based on the test set (n = 140 patients; 758 ECG-biopsy pairs). The AI-ECG detected ACR with an area under the receiver operating curve (AUC) of 0.84 (95% CI: 0.78-0.90) and 95% (19/20; 95% CI: 75%-100%) sensitivity. A prospective proof-of-concept screening study (n = 56; 97 ECG-biopsy pairs) showed the AI-ECG detected ACR with AUC = 0.78 (95% CI: 0.61-0.96) and 100% (2/2; 95% CI: 16%-100%) sensitivity. Conclusion An AI-ECG model is effective for detection of moderate to severe ACR in heart transplant recipients. Our findings could improve transplant care by providing a rapid, non-invasive, and potentially remote screening option for cardiac allograft function.

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Section: Discussionmentioning

confidence: 99%

Non-invasive detection of cardiac allograft rejection among heart transplant recipients using an electrocardiogram based deep learning model

Adedinsewo

Hardway

Morales-Lara

et al. 2023

European Heart Journal - Digital Health

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“…Moreover, donor age is a significant anticipator of low cardiac output syndrome that gradually caught up with those of early preserved output patients [76]. Acute cellular rejection, one of the main remained postoperative complications after heart transplantation, is defined by an inflammatory infiltrate possibly associated with damage to the heart [105]. This complication is assigned grades of 0-4, based on the cause of infiltrating or the damage to myocardial and vascular components,…”

Section: Low Cardiac Output Syndrome and Early Graft Dysfunctionmentioning

confidence: 99%

Early Postoperative Cardiac Complications Following Heart Transplantation

Negargar

Sadeghi

2023

GMJ

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Cardiovascular disorders remain the leading cause of death around the world. Heart transplantation is considered the only therapeutic choice defined as the gold standard strategy to manage end-stage heart failure. Nevertheless, the remaining postoperative complications compromise both the survival rate and quality of life in heart transplantation recipients. The present study aimed to review the current findings concerning the main early complications after heart transplantation, reliable predictors, diagnostic approaches, novel surgical techniques, and management strategies. The results demonstrated that significant advances in immunosuppressive pharmaceuticals, determining appropriate policies for donor acceptance, pre and post-operative treatment/care, selection of the most compatible donor with the recipient, and the suggestion of novel diagnostic and surgical techniques over the past decade had dropped the mortality and morbidity rates early after transplantation. However,marrhythmia, atrial flutter, atrial fibrillation, deep sternal wound infection along with other sites infections, low cardiac output syndrome, acute graft dysfunction, pericardial effusion, constrictive pericarditis, and acute cellular rejection could be considered as the major early complications following heart transplantations that pivotally require further investigations.

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“…Assessment of these miRNAs in patient sera permitted very high accuracy discrimination between patients with and without allograft rejection. Since then, several observational studies, mostly case-control and single-center studies, have identified various miRNAs as non-invasive biomarkers of rejection, mostly ACR: miR-144-3p [ 44 ], miR-181a-5p [ 45 ], miR-142-3p and miR-101-3p [ 46 ], and miR-29c-3p and miR-486-5p [ 47 ]. Despite the broad analysis of unselected miRNA in most of the recent studies, the heterogeneity in the type of miRNA identified across studies is striking and suggests a high degree of variability in the results.…”

Section: Non-invasive Biomarkers Of Rejection To Minimize Routine End...mentioning

confidence: 99%

A Review of Biomarkers of Cardiac Allograft Rejection: Toward an Integrated Diagnosis of Rejection

2022

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Despite major advances in immunosuppression, allograft rejection remains an important complication after heart transplantation, and it is associated with increased morbidity and mortality. The gold standard invasive strategy to monitor and diagnose cardiac allograft rejection, based on the pathologic evaluation of endomyocardial biopsies, suffers from many limitations including the low prevalence of rejection, sample bias, high inter-observer variability, and international working formulations based on arbitrary cut-offs that simplify the landscape of rejection. The development of innovative diagnostic and prognostic strategies—integrating conventional histology, molecular profiling of allograft biopsy, and the discovery of new tissue or circulating biomarkers—is one of the major challenges of translational medicine in solid organ transplantation, and particularly in heart transplantation. Major advances in the field of biomarkers of rejection have paved the way for a paradigm shift in the monitoring and diagnosis of cardiac allograft rejection. We review the recent developments in the field, including non-invasive biomarkers to minimize the number of protocol endomyocardial biopsies and tissue biomarkers as companion tools of pathology to refine the diagnosis of cardiac rejection. Finally, we discuss the potential role of these biomarkers to provide an integrated bio-histomolecular diagnosis of cardiac allograft rejection.

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Diagnostic value of serum miR-144-3p for the detection of acute cellular rejection in heart transplant patients

Cited by 15 publications

References 36 publications

Non-invasive detection of cardiac allograft rejection among heart transplant recipients using an electrocardiogram based deep learning model

Non-invasive detection of cardiac allograft rejection among heart transplant recipients using an electrocardiogram based deep learning model

Early Postoperative Cardiac Complications Following Heart Transplantation

A Review of Biomarkers of Cardiac Allograft Rejection: Toward an Integrated Diagnosis of Rejection

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