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

Higher levels of allograft injury in black patients early after heart transplantation. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Doshi, A., Shah, K. B., Agbor-Enoh, S., Tushak, Z., Garcia, V., Kong, H., Jang, M. K., Hsu, S., Feller, E. D., Rodrigo, M. E., Najjar, S. S., Tunc, I., Yang, Y., Lee, S., Solomon, M. A., Berry, G., Marboe, C., Shah, P., Valantine, H. A. 1800

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.

View details for DOI 10.1016/j.healun.2021.12.006

View details for PubMedID 35016813