Highlights
- •8 events reported at access site from EMB vs 3 events from AlloMap® testing.
- •Patients experienced less pain from an AlloMap® test than from an EMB.
- •There was no significant difference in the anxiety levels and adverse events.
Abstract
Background
Heart transplant recipients must regularly be assessed for graft rejection; however,
endomyocardial biopsy (EMB), can be stressful, painful, and inconvenient. AlloMap®
is the only commercially available non-invasive test for graft rejection. Current
guidelines include AlloMap® testing in low-risk patients
Objectives
To examine the patients’ perspective, this study compared patients’ experiences of
AlloMap® and EMB surveillance at our center.
Methods
We enrolled consecutive heart transplant recipients who were to undergo routine EMB
and AlloMap® testing (on different visits) to quantify their anxiety on the GAD-7
scale and their pain level on the Polyclinic Pain Scale. We assessed paired differences
of anxiety and pain within patients according to surveillance method.
Results
We studied 43 participants (median age 60.5[54, 66] years; 35(81%) men; 27(63%) Caucasian).
The median GAD-7 scores were 1[0, 4] and 2[0, 5] prior to EMB and AlloMap®, respectively
(paired difference: 0[-1, 1],P = 0.323). The median pain scores were 1[0, 1] and 0[0, 0] for EMB and AlloMap®, respectively.
Patients experienced less pain with AlloMap® testing compared to EMB (EMB–AlloMap;1[0,
1],P = 0.006). Seven (16%) participants experienced a total of 9 adverse events (pain,
bruising, bleeding, swelling) from EMB vs 2(5%) participants who experienced a total
of 3 adverse events (pain, bruising) from AlloMap®(P = 0.059).
Conclusion
Heart transplant recipients had less pain and fewer adverse events while undergoing
graft rejection surveillance with AlloMap® testing compared to EMB. An additional
benefit of AlloMap® testing is that it may be performed at home and reduce these high-risk
patients’ infectious exposures.
Key Words
Abbreviation:
EMB (Endomyocardial biopsy), GAD-7 (Generalized anxiety disorder-7), GEP (Gene expression profile)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 23, 2022
Accepted:
August 3,
2022
Received in revised form:
April 22,
2022
Received:
February 2,
2022
Identification
Copyright
© 2022 Published by Elsevier Inc.
