Heart and lung transplant patients may no longer need biopsies

Biomarkers may reduce need for biopsies
Heart and lung transplant patients may no longer need biopsies and could receive personalized care from biomarkers

From the International Society for Heart and Lung Transplantation:
BOSTON, MA April 10, 2008 – Data presented at this week’s 28th Annual Meeting and Scientific Sessions of the International Society for Heart and Lung Transplantation (ISHLT) suggest the potential of a significant impact of using biomarkers to reduce the need for biopsies and personalize transplant patient care. Non-invasive testing using gene-based blood or urine samples called biomarkers could offer transplant patients personalized care and medication and may replace the need for costly, invasive biopsy procedures that can be risky for patients. The meeting will run through Saturday at the Boston Marriott Copley Place and Hynes Convention Center.

Personalized care is an integrative process of tailoring care to an individual patient’s characteristics or preferences, based on each individual’s unique biology, behavior and environment. At this year’s meeting, researchers are presenting data from gene and protein based blood testing that may be helpful for reducing immunosuppression. Related data suggests gene analysis may allow for prediction of future occurrence of cardiac allograft rejection and its diagnosis.

FEATURED DISCUSSION

Today’s plenary lectures provide current perspectives on biomarkers in transplantation. In Biomarkers: What Are They" How Might They Aid in Care of Allograft Recipients and Other Patients, Christopher J. O’Donnell, MD, MPH, from NIH National Heart, Lung and Blood Institute/Framingham Heart Study, Framingham, MA, will present data pertaining to personalized care, its benefits and future impact on heart and lung patients.

Following, Dr. Christoph Borchers, Director of the Genome Canada Proteomics Platform at the University of Victoria, British Columbia, will provide a look at the emerging strategies for plasma protein analysis in New Tools, Technologies and Results for Probing Proteomic Biomarkers in Plasma of Transplant Patients.

Finally, Dr. Ralph Weissleder from Massachusetts General Hospital/Harvard will discuss Imaging Biomarkers: New Horizons and Opportunities in Transplantation, and will share the latest information on imaging biomarkers and how advanced imaging techniques may soon help in the management of transplant patients. Three related biomarker abstracts are also slated for presentation during the session.

“In recent years, there has been an intensive focus on enhancing our ability to provide the most particular predictive, diagnostic, prognostic and therapeutic guidance for patients. This intent has been enabled by unbiased and targeted examination of genotypes and haplotypes that may convey risk or protection against certain disease processes like immune rejection, as well as by defining the molecular signatures of a disease process like rejection by measuring mRNA, proteins or metabolites in the blood or urine. Distillation of such data, along with clinical features, is intended to improve care, reduce costs, and make patients lives more enjoyable,” said Bruce McManus, MD, PhD, University of British Columbia, one of the Co-Chairs for the biomarkers plenary session.

Until recently, heart muscle biopsy was the only method available to rule out heart transplant rejection and guide treatment with anti-rejection, or immunosuppressive, therapy. Aside from the invasive and painful nature of the procedure, a biopsy is only able to detect rejection after damage has already occurred to the heart tissue. Similar dilemmas exist in the monitoring of lung transplant recipients.

Alternatively, non-invasive molecular testing of a routine blood sample allows analysis of gene expression in white blood cells, proteins in the plasma, and metabolites in blood and urine. The latter biomarkers provide information on the immune, inflammatory and injury status of the transplanted heart before tissue damage occurs. The new and original information on biomarkers and personalized care in lectures given at ISHLT will offer a deeper knowledge of this innovative direction that is revolutionizing health care. The discussion will also raise awareness of alternatives to biopsy procedures that are on the horizon.

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About ISHLT

The International Society for Heart and Lung Transplantation (ISHLT) is a not-for-profit organization dedicated to the advancement of the science and treatment of end-stage heart and lung diseases. Created in 1981, the society now includes more than 3,000 members from more than 45 countries, representing a variety of disciplines involved in the management and treatment of end-stage heart and lung disease.

ISHLT maintains two vital databases. The International Heart and Lung Transplant Registry is a one-of-a-kind registry that has been collecting data since 1983 from 223 hospitals from 18 countries. The ISHLT Mechanical Circulatory Device (MCSD) database has been collecting data since 2002 with the aim of identifying patient populations who may benefit from MCSD implantation; generating predictive models for outcomes; and assessing the mechanical and biological reliability of current and future devices. In fall 2006, ISHLT released the first international guidelines for heart failure patient management. For more information, visit ISHLT web site.

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