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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