Injury of transplant tissue by a transplant recipient's immune system continues to be the leading cause of graft rejection and recipient death. The purpose of this study is to identify a single test or a combination of noninvasive tests currently used for heart transplant monitoring that correlate to long-term graft survival.
A major cause of heart transplant failure is the blockage of blood flow from lesions caused by ongoing injury and repair of the graft by the host's immune system. However, the role of T cells, antibodies, and other parts of the recipient's immune system are not well understood in transplant injury. Currently, there are no effective, noninvasive ways to detect or predict how an individual's immune system will react to a transplant. The purpose of this study is to correlate current noninvasive monitoring tests with long-term graft survival and function, and determine which tests are the most accurate predictors of this survival. Participants in this study must currently be on the waiting list for a heart transplant and have a donor heart available to them. This study will consist of six study visits over 12 months. The baseline visit will occur on the day of transplantation. Follow-up visits will occur at Week 6 and Months 3, 6, 9, and 12 post-transplant. At each visit, a physical exam, medication tracking, assessment of graft survival, and blood and urine collection will occur. At the Week 6 and Month 12 visits, intravascular ultrasound and echocardiograms will occur. At the Week 6, Month 6, and Month 12 visits, endomyocardial biopsies will also occur. No immunosuppressive therapy will be provided by the study.
Study Type
OBSERVATIONAL
Enrollment
263
People in this study will have a heart transplant and be monitored for signs of rejection
University of California
San Francisco, California, United States
Northwestern University Medical School
Chicago, Illinois, United States
Loyola University School of Medicine
Maywood, Illinois, United States
Composite Measure of Transplant Health
A composite of incidence of the following: * Death, * Re-transplantation or re-listed for transplantation, * Biopsy proven acute rejection (BPAR) of \> 2R, * Episode of rejection associated with hemodynamic compromise, * Coronary artery vasculopathy defined by a change in MIT of \>0.5 mm between study entry and 12 months.
Time frame: 12 months after enrollment in study
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University of Maryland
Baltimore, Maryland, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
Brigham and Women's Hospital
Boston, Massachusetts, United States
Beth Israel Medical Center
Newark, New Jersey, United States
Mount Sinai School of Medicine
New York, New York, United States
The Cleveland Clinic Foundation
Cleveland, Ohio, United States
Medical City Dallas Hospital
Dallas, Texas, United States
...and 2 more locations