OPtimal Adult Heart Transplant Immunosuppression With MicroRNA Levels (Optimal)

Inova Health Care Services

Status: Not yet enrolling

Conditions: Cardiac Failure; Graft Rejection

Study type: Observational

Funder types: Other; NIH

Identifiers

NCT06939751

1R01HL173248-01A1 (U.S. NIH Grant/Contract)

INOVA-2024-372

Details and patient eligibility

About

This study aims to develop and refine a miR biomarker panel that can be used to phenotype net immune state after heart transplantation.

Full description

The study objectives will be accomplished in a prospective, longitudinal, multicenter, multiracial, multiethnic cohort study that includes adult heart transplant patients from geographically and socioeconomically diverse regions of the U.S. Patients will be screened for eligibility and enrolled ~1 month (± 2 weeks) after transplant.

All patients will follow the center's standard of care surveillance schedule after transplant. Blood samples will be collected for miR evaluation at

1. specified time intervals after transplant
2. when a clinical event of interest occurs, including rejection or infection.

Research samples will be collected and used to evaluate microRNA expression as well as other biomarkers related to heart transplantation and immunosuppressive medications. Additional data collection will include demographics, medical history, medications, human leukocyte (HLA)/donor specific antibody (DSA) evaluations, endomyocardial biopsy (EMB), echocardiography, donor-derived cell-free DNA (dd-cfDNA), and other post-transplant events and testing.

Enrollment: 250 estimated patients

Sex: All

Ages: 18 to 99 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥ 18 years at enrollment
• Receipt of orthotopic heart transplant (OHT) within the prior 1 month ± 2 weeks
• Planned follow-up at the transplant center for a minimum of one-year.
• Patient able and willing to comply with the study visit schedule, study procedures, and study requirements.

Exclusion criteria

• Recipient of a multi-organ transplant
• History of prior solid organ transplant before the index heart transplant
• Ongoing mechanical circulatory support or hemodynamic instability (e.g., inotrope or vasopressor therapy)
• Ongoing need for renal replacement therapy and/or dialysis
• Active infection requiring either a) hospitalization b) treatment with antimicrobial therapy or c) reduction in immunosuppression
• Active rejection being treated with intravenous medications or plasmapheresis