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用于监测心脏移植的分子诊断技术。

Molecular diagnostics for the monitoring of the cardiac allograft.

作者信息

Truby Lauren K, Teuteberg Jeffrey

机构信息

Assistant Professor of Medicine, Associate Medical Director, Adult Heart Transplant Program, Advanced Heart Failure and Transplantation, Department of Medicine, Division of Cardiology, UT Southwestern Medical Center, 5959 Harry Hines Boulevard, Dallas, TX 75390.

Associate Chief of Cardiology, Section Chief of Heart Failure, Cardiac Transplant and Mechanical Circulatory Support, Professor of Medicine, Division of Cardiology, CV 285, Falk Building, 300 Pasteur Drive, Stanford, CA 94305.

出版信息

JHLT Open. 2025 Jul 25;10:100354. doi: 10.1016/j.jhlto.2025.100354. eCollection 2025 Nov.

DOI:10.1016/j.jhlto.2025.100354
PMID:40837540
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12362087/
Abstract

Heart transplantation (HT) remains the optimal long-term therapy to improve survival in eligible patients living with end-stage heart disease. Monitoring the health of the allograft over its lifespan is critical to ensure the rapid diagnosis of immunologic, vascular, and myocardial events to enable the timely deployment of appropriate medical therapies. Advances in next-generation sequencing are being applied to screening for allograft rejection to the early detection of malignancy and have already been integrated into the routine care of HT recipients. Further personalization of care by integrating omics and imaging technologies, combined with novel data analysis methods, is at hand.

摘要

心脏移植(HT)仍然是改善终末期心脏病患者生存的最佳长期治疗方法。在同种异体移植物的整个生命周期内监测其健康状况对于确保快速诊断免疫、血管和心肌事件至关重要,以便能够及时部署适当的药物治疗。下一代测序技术的进展正被应用于同种异体移植物排斥反应的筛查以及恶性肿瘤的早期检测,并且已经被纳入心脏移植受者的常规护理中。通过整合组学和成像技术以及新颖的数据分析方法来进一步实现个性化护理已近在咫尺。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dfd/12362087/107e793f3920/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dfd/12362087/107e793f3920/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dfd/12362087/107e793f3920/ga1.jpg

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本文引用的文献

1
Computational pathology assessments of cardiac stromal remodeling: Clinical correlates and prognostic implications in heart transplantation.心脏基质重塑的计算病理学评估:心脏移植中的临床相关性及预后意义
JHLT Open. 2024 Dec 28;7:100202. doi: 10.1016/j.jhlto.2024.100202. eCollection 2025 Feb.
2
Pathologist interrater reliability and clinical implications of elevated donor-derived cell-free DNA beyond heart transplant rejection, on behalf of the GRAfT investigators.代表移植研究组,探讨病理学家评分者间可靠性以及心脏移植排斥反应之外供体来源游离DNA升高的临床意义。
J Heart Lung Transplant. 2025 May;44(5):803-812. doi: 10.1016/j.healun.2024.10.006. Epub 2024 Oct 17.
3
Lack of Association Between Donor-Derived Cell-Free DNA and Cardiac Allograft Vasculopathy.
供体来源的无细胞 DNA 与心脏移植物血管病之间缺乏关联。
Clin Transplant. 2024 Jul;38(7):e15416. doi: 10.1111/ctr.15416.
4
European Society for Organ Transplantation (ESOT) Consensus Statement on the Use of Non-invasive Biomarkers for Cardiothoracic Transplant Rejection Surveillance.欧洲器官移植学会(ESOT)关于使用非侵入性生物标志物进行心胸器官移植排斥监测的共识声明。
Transpl Int. 2024 Jun 11;37:12445. doi: 10.3389/ti.2024.12445. eCollection 2024.
5
Donor plasma VEGF-A as a biomarker for myocardial injury and primary graft dysfunction after heart transplantation.供体血浆血管内皮生长因子A作为心脏移植后心肌损伤和原发性移植物功能障碍的生物标志物。
J Heart Lung Transplant. 2024 Oct;43(10):1677-1690. doi: 10.1016/j.healun.2024.06.004. Epub 2024 Jun 17.
6
Precision diagnostics in transplanted organs using microarray-assessed gene expression: concepts and technical methods of the Molecular Microscope® Diagnostic System (MMDx).利用微阵列评估基因表达进行移植器官的精准诊断:Molecular Microscope® Diagnostic System(MMDx)的概念和技术方法。
Clin Sci (Lond). 2024 Jun 5;138(11):663-685. doi: 10.1042/CS20220530.
7
Surveillance with dual noninvasive testing for acute cellular rejection after heart transplantation: Outcomes from the Surveillance HeartCare Outcomes Registry.心脏移植后采用双重非侵入性检测进行急性细胞排斥反应监测:来自 Surveillance HeartCare Outcomes 注册研究的结果。
J Heart Lung Transplant. 2024 Sep;43(9):1409-1421. doi: 10.1016/j.healun.2024.05.003. Epub 2024 May 15.
8
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Cardiovasc Pathol. 2024 Sep-Oct;72:107646. doi: 10.1016/j.carpath.2024.107646. Epub 2024 Apr 26.
9
Racial Differences in Donor-Derived Cell-Free DNA and Mitochondrial DNA After Heart Transplantation, on Behalf of the GRAfT Investigators.代表 GRAfT 研究人员的心脏移植后供体游离 DNA 和线粒体 DNA 的种族差异。
Circ Heart Fail. 2024 Apr;17(4):e011160. doi: 10.1161/CIRCHEARTFAILURE.123.011160. Epub 2024 Feb 20.
10
Metabolomic profiling during ex situ normothermic perfusion before heart transplantation defines patterns of substrate utilization and correlates with markers of allograft injury.在心脏移植前的体外常温灌流过程中进行代谢组学分析,可定义底物利用模式,并与移植物损伤标志物相关。
J Heart Lung Transplant. 2024 May;43(5):716-726. doi: 10.1016/j.healun.2023.12.002. Epub 2023 Dec 7.