Virtual Biopsy Set to Transform Heart Transplant Care

The days of heart transplant survivors undergoing invasive biopsies may soon be over after a new MRI technique is proven to be safe and effective; reduce complications and hospitalizations.

Scientists from the Victor Chang Cardiac Research Institute and St Vincent’s Hospital in Sydney hope the new virtual biopsy designed to detect any signs of cardiac rejection will be adopted by clinicians around the world.

Approximately 3,500 people worldwide receive heart transplants each year. Most patients experience some form of organ rejection, and although survival rates are high, a small percentage will die within the first year after surgery.

Associate Professor Andrew Jabbour, of the Victor Chang Cardiac Research Institute, said the new development will lead to major improvements in care for many thousands of heart transplant patients worldwide.

“It is essential that we can follow these patients closely and with great precision; we now have a new tool that can do this without the need for a highly invasive procedure, said Acting Professor Jabbour, who is also a consultant cardiologist at St Vincent’s Hospital in Sydney.

“This new virtual biopsy takes less time, is non-invasive, more cost-effective, uses no radiation or contrast agent, and most importantly patients greatly prefer it.”

Most clinicians around the world currently test for rejection by performing a biopsy which helps determine the level and appropriateness of immunosuppressive treatments needed to treat and prevent further rejection.

This invasive procedure involves placing a tube in the jugular vein to allow surgeons to insert a biopsy tool into the heart to take multiple samples of heart tissue.

Besides being uncomfortable, it can also lead to rare but serious complications if the heart is punctured or a valve is damaged. Patients typically undergo biopsy about 12 times during the first year after transplantation.

The new MRI technique has been shown to be accurate at detecting rejection and works by analyzing levels of cardiac edema which the team believe are closely associated with inflammation of the heart.

Principle results

• Forty heart transplant patients from St Vincent’s Hospital in Sydney were randomized to receive either a traditional biopsy or the new MRI technique.
• Results published in the journal Circulation found that the new test was just as good at detecting rejection.
• Secondary results of the study revealed that despite the similarities in immunosuppression requirements, kidney function and mortality rates, there was a reduction in hospitalization and infection rates for those who underwent the procedure. MRI versus biopsy. Additionally, only six percent of patients with the new MRI technique needed a biopsy for clarification. These secondary results are intended to be reconfirmed in larger planned multicenter studies.

Dr Chris Anthony, author and cardiologist, who helped conduct the study, said: “The technique is now in frequent use at St Vincent’s Hospital in Sydney, and I anticipate that more clinics around the world will adopt this technique. new technology.”

Next steps

The Institute and St Vincent’s team are now planning a larger multicenter trial to broaden the applicability of the results and include pediatric transplant recipients.

They are also developing new genetic tests to be used alongside MRIs that it is hoped will detect signs of rejection by identifying genetic signals of donor-specific inflammation in the bloodstream. The new technique will also be suitable for detecting heart inflammation in the wider population, not just in transplant recipients.