Key result
The molecular microscope diagnostic system (MMDx) is suggested to assist with early detection of rejection in heart transplant recipients when endomyocardial biopsy and other noninvasive studies are discordant.
Why the study?
Endomyocardial biopsy for graft rejection surveillance after heart transplantation carries potential complications and limitations like interobserver variability, prompting the need to review tools like the molecular microscope diagnostic system alongside noninvasive screening modalities.
Does the molecular microscope diagnostic system (MMDx) improve early detection of graft rejection in heart transplant recipients compared to standard endomyocardial biopsy?
Does the molecular microscope diagnostic system (MMDx) improve early detection of graft rejection in heart transplant recipients compared to standard endomyocardial biopsy?
MMDx may serve as a useful adjunct for detecting graft rejection in heart transplant recipients when standard biopsy and noninvasive tests are discordant.
May support MMDx as adjunct in discordant cases; leaves open prospective validation before practice change.
INTRODUCTION: Monitoring for graft rejection is a fundamental tenet of post-transplant follow-up. In heart transplantation (HT) in particular, rejection has been traditionally assessed with endomyocardial biopsy (EMB). EMB has potential complications and noted limitations, including interobserver variability in interpretation. Additional tests, such as basic cardiac biomarkers, cardiac imaging, gene expression profiling (GEP) scores, donor-derived cell-free DNA (dd-cfDNA) and the novel molecular microscope diagnostic system (MMDx) have become critical tools in rejection surveillance beyond standard EMB. METHODS: This paper describes an illustrative case followed by a review of MMDx within the context of other noninvasive screening modalities for rejection. CONCLUSIONS: We suggest MMDx be used to assist with early detection of rejection in cases of discordance between EMB and other noninvasive studies.
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Mehlman et al. (2023) conducted a review in Heart transplant recipients. Molecular microscope diagnostic system (MMDx) vs. Endomyocardial biopsy (EMB) and other noninvasive studies was evaluated. The molecular microscope diagnostic system (MMDx) is suggested to assist with early detection of rejection in heart transplant recipients when endomyocardial biopsy and other noninvasive studies are discordant.
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