Low AlloSure® in HeartCare® Associated with Low Risk of Significant Allograft Rejection: An Analysis of SHORE

PurposeHeartCare is a non-invasive method of surveillance for cardiac allograft rejection comprised gene expression profiling (AlloMap, AM) and donor derived cell-free DNA (AlloSure-Heart, AS). AM scores inform immune quiescence whereas AS reflects presence tissue injury.MethodsSurveillance HeartCare Outcomes Registry (SHORE) multicenter, observational registry assessing the clinical utility AS/AM. score >30 (<6 months) or > 34 (≥6 was deemed positive (AM+). result >0.15% defined as (AS+). The acute cellular ≥2R antibody mediated (AMR 1, 2, 3) assessed at 14 30 days following AS/AM.ResultsOf 4927 samples analyzed, 2507 (50.9%) were concordant low (AS-/AM-), 558 (11.3%) AS+/AM+. Discordance noted in 1245 (25.3%) with AS+/AM- 617 (12.5%) AS-/AM+. AS+/AM+ cohort had significantly more events when compared AS-/AM- group (1.25% vs 0.4%, p = 0.032) trend toward (1.61% 0.68%, 0.055). AS-/AM+ fewer episodes those (0.16% 1.61%, 0.017) 1.25%, fewest number endomyocardial biopsies performed to all other cohorts (p < 0.05).ConclusionAS/AM provides complementary information regarding probability clinically significant rejection. In discordant results, associated lower risk subsequent days. A concordantly may safely obviate biopsy appropriately selected. injury. Surveillance Of 0.05). AS/AM