Does gene-expression profile testing accurately rule out acute cellular rejection in heart transplant recipients?
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.
For ≥2-6 and >6 months post-transplantation, CARGO II GEP score performance (AUC-ROC = 0.70 and 0.69) is similar to the CARGO study results (AUC-ROC = 0.71 and 0.67). The low prevalence of ACR contributes to the high NPV and limited PPV of GEP testing. The choice of threshold score for practical use of GEP testing should consider overall clinical assessment of the patient's baseline risk for rejection.
Crespo‐Leiro et al. (Thu,) studied this question.
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