Higher levels of allograft injury in black patients early after heart transplantation

Amar Doshi, Keyur B. Shah, Sean Agbor-Enoh, Zackary Tushak, Victoria Garcia, Hyesik Kong, Moon K. Jang, Steven Hsu, Erika D. Feller, Maria E. Rodrigo, Samer S. Najjar, Ilker Tunc, Yanqin Yang, Seiyon Lee, Michael A. Solomon, Gerald Berry, Charles Marboe, Palak Shah, Hannah A. Valantine

Research output: Contribution to journalArticlepeer-review

Abstract

Black patients suffer higher rates of antibody-mediated rejection and have worse long-term graft survival after heart transplantation. Donor-derived cell free DNA (ddcfDNA) is released into the blood following allograft injury. This study analyzed %ddcfDNA in 63 heart transplant recipients categorized by Black and non-Black race, during the first 200 days after transplant. Immediately after transplant, %ddcfDNA was higher for Black patients (mean [SE]: 8.3% [1.3%] vs 3.2% [1.2%], p = 0.001). In the first week post-transplant, the rate of decay in %ddcfDNA was similar (0.7% [0.68] vs 0.7% [0.11], p = 0.78), and values declined in both groups to a comparable plateau at 7 days post-transplant (0.46% [0.03] vs 0.45% [0.04], p = 0.78). The proportion of Black patients experiencing AMR was higher than non-Black patients (21% vs 9% [hazard ratio of 2.61 [95% confidence interval: 0.651-10.43], p = 0.18). Black patients were more likely to receive a race mismatched organ than non-Black patients (69% vs 35%, p = 0.01), which may explain the higher levels of early allograft injury.

Original languageEnglish (US)
Pages (from-to)855-858
Number of pages4
JournalJournal of Heart and Lung Transplantation
Volume41
Issue number7
DOIs
StatePublished - Jul 2022

Keywords

  • acute rejection
  • biomarker
  • cardiac transplantation
  • cell-free DNA
  • graft injury

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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