Established over 40 years ago, our heart transplantation program is the largest and most experienced program in the United States. Our doctors continuously pursue innovative treatment protocols, including treatment for high-risk and multi-organ (heart-lung, heart-liver, and heart-kidney) transplant populations.
Heart Failure Research Institute
Advancing the understanding, prevention, and treatment of heart failure through research
Heart Transplantation
Research Highlights
Donor-derived cell-free DNA
- This research focuses on enhancing monitoring for heart transplant rejection through the use of a non-invasive biomarker (donor-derived cell-free DNA) to measure small amounts of cellular damage. This biomarker can detect rejection much earlier in the course, prior to the development of clinical symptoms, along with other biomarkers including peripheral Gene Expression Profiling. The research aims to:
- Identify the accuracy of donor-derived cell-free DNA for diagnosing rejection in comparison to the gold standard of biopsy and pathological analysis
- Evaluate the additive benefit of gene expression profiling to the results of donor-derived cell-free DNA
- Measure the prognostic value of donor-derived cell-free DNA for long-term patient and graft survival
- Examine the association of donor-derived cell-free DNA with the development of complications related to transplantation, including the development of donor-specific antibodies and cardiac allograft vasculopathy
- The significance of this research is its potential to shift rejection surveillance in heart transplantation from invasive testing (biopsies) to a non-invasive, reliable alternative. This could lead to earlier detection of rejection and improved patient care.
MMDx (Molecular Microscope)
- Molecular microscope is a novel tool that uses gene expression measured on heart biopsy specimens to detect signals for rejection
- This research investigates the clinical effectiveness of molecular microscope testing when used as an adjunct to current methods to detect rejection, including biomarkers (donor-derived cell-free DNA), donor-specific antibodies, and traditional histological analysis of biopsy specimens
- We are exploring how molecular microscope testing may provide additional information that can change therapeutic decision-making. We are also analyzing changes in molecular microscope signals following specific therapies.
- We are further assessing the long-term prognosis of specific molecular microscope results to better understand the test’s clinical significance
- The importance of this research is that the accuracy of histological analysis of biopsies, currently the gold standard, has come into question due to the frequency of clinical signs of rejection with negative biopsy results. Molecular microscope may offer additional information that can supplement traditional methods for determining rejection and improve our ability to detect rejection early, prior to significant myocardial damage.
Belatacept (BTC)
- Belatacept is a novel immunosuppression agent that has a different side-effect profile than the agents traditionally used to prevent rejection in heart transplantation. A noted benefit of belatacept is its neutral effect on kidney function, in comparison to the renal toxicity that is common with calcineurin inhibitors.
- Belatacept has been improved for use in kidney transplantation, but data about its efficacy and safety in heart transplantation are limited
- This research aims to establish the benefits and risks of belatacept use in heart transplantation through the examination of our center’s experience
Letermovir
- Letermovir is an antiviral medication that has specificity for cytomegalovirus (CMV). Due to its low side effect profile, letermovir may have advantages over valganciclovir, which is commonly used to prevent CMV infection in solid organ transplantation. Specifically, valganciclovir therapy may be limited by bone marrow suppression, which has not been seen with letermovir.
- This research aims to establish the efficacy and safety of letermovir in a heart transplant population
Recent publications
Sex Differences in Cardiac Transplantation
Chung A, Hartman H, DeFilippis EM. Curr Atheroscler Rep. 2023 Dec 7. doi: 10.1007/s11883-023-01169-0. Online ahead of print.
New system, old problem: Increased wait time for high-priority transplant candidates
Harris E, Sewanan L, Topkara VK, Fried JA, Raikhelkar J, Colombo PC, Yuzefpolskaya M, DeFilippis EM, Latif F, Takeda K, Singh S, Uriel N, Sayer G, Clerkin KJ. J Heart Lung Transplant. 2023 Nov;42(11):1497-1500. doi: 10.1016/j.healun.2023.07.012. Epub 2023 Jul 26.
Harnessing Precision Medicine: HLA or Eplet Matching in Heart Transplantation
Defilippis EM, Lacelle C, Garg S, Farr M. J Card Fail. 2023 Oct 26:S1071-9164(23)00375-5. doi: 10.1016/j.cardfail.2023.09.010. Online ahead of print.
Mehlman Y, Valledor AF, Moeller C, Rubinstein G, Lotan D, Rahman S, Oh KT, Bae D, DeFilippis EM, Lin EF, Lee SH, Raikhelkar JK, Fried J, Theodoropoulos K, Colombo PC, Yuzefpolskaya M, Latif F, Clerkin KJ, Sayer GT, Uriel N. Clin Transplant. 2023 Dec;37(12):e15131. doi: 10.1111/ctr.15131. Epub 2023 Oct 28.
Pregnancy as a Sentinel Event: Preventing Severe Maternal Morbidity in Heart Transplant Recipients
DeFilippis EM, Kittleson MM. JACC Heart Fail. 2023 Dec;11(12):1675-1677. doi: 10.1016/j.jchf.2023.09.003. Epub 2023 Oct 18.
A change of heart: Characteristics and outcomes of multiple cardiac retransplant recipients
Batra J, DeFilippis EM, Clerkin K, Bae D, Oh KT, Lotan D, Topkara VK, Lee SH, Latif F, Colombo P, Yuzefpolskaya M, Raikhelkar J, Majure DT, Sayer G, Uriel N. Clin Transplant. 2023 Dec 11:e15214. doi: 10.1111/ctr.15214. Online ahead of print.
Bhagra CJ, Cherikh WS, Ross H, Kittleson MM, Stehlik J, Lewis A, DeFilippis EM, Macera F. J Heart Lung Transplant. 2023 Dec 13:S1053-2498(23)02165- 4. doi: 10.1016/j.healun.2023.12.003. Online ahead of print.
Rahman A, Golombeck D, Malhame K, Rossi D, Wallach F, Avila M, Maybaum S. Transplantation. 2023 Dec 1;107(12):e370-e372. doi: 10.1097/TP.0000000000004843. Epub 2023 Oct 30.
