The Impact of Time Post Cardiac Transplant on Gene Expression Profile Scores, an Analysis of 32,043 Tests
|Bethany A Austin1 , PJ Arnold2 and Andrew Kao1 *|
|1 Cardiology, Saint Luke’s Mid America Heart Institute, Kansas City, MO, USA|
|2 XDx, Inc., Brisbane, CA, USA|
|Corresponding Author :||Andrew Kao, MD
Saint Luke’s Cardiovascular Consultants
4330 Wornall Road, Suite 2000
Kansas City, MO, USA
E-mail: [email protected]
|Received June 10, 2013; Accepted July 09, 2013; Published July 16, 2013|
|Citation: Austin BA, Arnold PJ, Kao A (2013) The Impact of Time Post Cardiac Transplant on Gene Expression Profile Scores, an Analysis of 32,043 Tests. J Cardiovasc Dis Diagn 1:114. doi: 10.4172/2329-9517.1000114|
|Copyright: © 2013 Austin BA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Background: Gene Expression Profiling (GEP) has been used since 2005 to identify Orthotopic Heart Transplant (OHT) recipients at low risk of allograft rejection. A rise in GEP scores during the first year post OHT has been previously reported. The purpose of this study is to confirm and better characterize this effect of time post-transplant in a larger, unselected cohort.
Methods: All commercially obtained GEP scores (XDx Inc., Brisbane, CA) collected between January 2005 and September 2011 were included. Clinical data were available for patient age, gender and dates of transplantation and tests.
Results: There were 32,043 GEP tests from 9,272 patients at 108 transplant centers (mean age at testing 54.2 ± 14.7 yrs, 25% women). There was a significant effect of time post transplant on GEP, which rose from 24.7 ± 7.8 at 2-6 months to 28.8 ± 5.8 at 7-12 months (p<0.0001) and 29.6 ± 5.0 (p<0.0001) at 13-24 months, after which it remained stable.
Conclusions: A rise in GEP scores is seen during the first year following OHT, which parallels the time frame of decreased corticosteroid dosing. Further study of this test characteristic may better inform clinical use of GEP testing in conjunction with endomyocardial biopsy.