A new non-invasive MRI technique, also known as a virtual biopsy, has been found to be safe, take less time and be more cost effective than the traditional biopsy method used for heart transplant survivors.
A study of 40 heart transplant patients from St Vincent’s Hospital, Sydney found that there was a reduction in hospitalisation and infection rates for those who underwent the MRI procedure vs a biopsy.
Scientists at the Victor Chang Cardiac Research Institute hope the new virtual biopsy designed to detect any signs of the heart being rejected will be adopted by clinicians across the globe.
Approximately 3,500 people worldwide receive heart transplants each year. Most patients experience some form of organ rejection and whilst survival rates are high, a small percentage will die in the first year after surgery.
‘Major improvements in care’ for many thousands of heart transplant patients
Associate Professor Andrew Jabbour, of the Victor Chang Cardiac Research Institute, said the new development will lead to major improvements in care for many thousands of heart transplant patients worldwide.
“It’s essential that we can monitor these patients closely and with a high degree of accuracy; now we have a new tool that can do that without the need for a highly invasive procedure,” said Professor Jabbour.
“This new virtual biopsy takes less time, is non-invasive, more cost-effective, uses no radiation or contrast agents, and most importantly patients much prefer it,” he added.
The new MRI technique has been proven to be accurate in detecting rejection
Most clinicians around the world currently test for rejection by performing a biopsy which helps determine the level and suitability of immunosuppressive treatments needed to treat and prevent further rejection.
This invasive procedure involves a tube being placed in the jugular vein to allow surgeons to insert a biopsy tool into the heart to remove multiple samples of heart tissue.
As well as being uncomfortable, it can also lead to rare but serious complications if the heart is perforated, or a valve is damaged. Patients usually undergo a biopsy around 12 times in the first year after transplantation.
The new MRI technique has been proven to be accurate in detecting rejection and works by analysing heart oedema levels which the team demonstrated are closely associated with inflammation of the heart.
The research team is now planning a larger multi-centre trial
The team at the Institute and St Vincent’s is now planning a larger multi-centre trial to broaden the applicability of the findings and incorporate paediatric transplant recipients.
They are also developing new genetic testing to be used alongside the MRI which it is hoped will detect signs of rejection through identifying genetic signals of donor-specific inflammation in the bloodstream. The new technique will also be adapted to detect heart inflammation in the wider population, not just transplant recipients.