Key result
dd-cfDNA frequently discordances with EMB in detecting allograft rejection, highlighting the need for combined surveillance.
Why the study?
Cardiac allograft rejection assessment methods EMB and dd-cfDNA show discordance, necessitating evaluation of causes and alignment strategies.
This review highlights the discordance between endomyocardial biopsy and dd-cfDNA for detecting cardiac allograft rejection and suggests strategies for better alignment.
Discordance between EMB and dd-cfDNA warrants cautious interpretation in rejection surveillance; leaves open optimal integration strategies.
Cardiac allograft rejection has traditionally been assessed by endomyocardial biopsy (EMB). Blood-based assays such as donor-derived cell-free DNA (dd-cfDNA) are increasingly used, yet emerging data highlight discordance between these approaches. This review evaluates recent data, examines causes of disagreement, and suggests strategies to better align EMB and dd-cfDNA.
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Fishbein et al. (2026) studied this question. Donor-derived cell-free DNA and traditional endomyocardial biopsy show discordance in assessing cardiac allograft rejection, requiring strategies to better align these approaches.
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