Publications by authors named "H A Valantine"
Background: Proteomic phenotyping can provide insights into rejection pathophysiology, novel biomarkers, and therapeutic targets.
Methods: Within the prospective, multicenter Genomic Research Alliance for Transplantation study, 181 proteins were evaluated from blood drawn at the time of endomyocardial biopsy; protein fold change, logistic regression, and pathway analyses were conducted, with protein discovery adjusted for a 5% false discovery rate.
Results: Among 104 adult heart transplant patients (31% female sex, 53% Black race, median age 52 y), 74 had no rejection, 18 developed acute cellular rejection (ACR), and 12 developed antibody-mediated rejection (AMR).
Article Synopsis
- Heart transplant patients with donor-specific antibodies (DSAs) face a higher risk of rejection, but some do not show antibody-mediated rejection despite having graft dysfunction.
- A study involved 216 participants undergoing serial evaluations like endomyocardial biopsy (EMB) and echocardiograms to understand the relationship between DSAs, rejection types, and long-term outcomes.
- Results indicated that both antibody-mediated rejection (pAMR+) and DSA-related left ventricle dysfunction significantly correlated with increased mortality and prolonged heart dysfunction, particularly if they occurred within the first six months after transplant.
Background: There is significant variability among pathologists in the histopathological interpretation of the endomyocardial biopsy (EMB) for acute cellular rejection (ACR), and assessment of variability in the interpretation of antibody-mediated rejection (AMR) has not been reported. In contemporary practice, the strategy of allograft surveillance with donor-derived cell-free DNA (dd-cfDNA) compared to EMB has not been compared with a focus on long-term clinical outcomes beyond acute rejection (AR).
Methods: The Genomic Research Alliance for Transplantation is a multicenter, prospective cohort study that enrolled patients from 2015 to 2020.