Clinical usefulness of gene-expression profile to rule out acute rejection after heart transplantation: CARGO II
Why the study?
Does gene-expression profile testing accurately rule out acute cellular rejection in heart transplant recipients?
Population
Heart transplant recipients
Comparison
Gene-expression profile testing vs Historical CARGO study results
Design
Cohort
Follow-up
≥2-6 and >6 months post-transplantation
Authors
Discussion
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Member takes
Implication
Supports high-NPV noninvasive ACR rule-out post-transplant; confirms CARGO performance in new cohort but leaves impact on outcomes open.
Structured PICO
Does gene-expression profile testing accurately rule out acute cellular rejection in heart transplant recipients?
P
Population
Heart transplant recipients
I
Intervention
Gene-expression profile (GEP) testing (CARGO II GEP score)
C
Comparator
Historical CARGO study results
O
Outcome
Diagnostic performance to rule out acute cellular rejection (ACR), measured by AUC-ROC, negative predictive value (NPV), and positive predictive value (PPV)surrogate
Gene-expression profiling provides a high negative predictive value to rule out acute cellular rejection after heart transplantation, performing similarly to the original CARGO study.
Limitations
- Low prevalence of ACR contributes to limited PPV of GEP testing
Cite This Study
Crespo‐Leiro et al. (2016) studied this question.