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American Heart Association

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Final ID: MDP251

Cardiac Thickening, Cell Free DNA, and Rejection in the 2nd Porcine Cardiac Xenograft

Abstract Body (Do not enter title and authors here): Introduction/Background: A 58-year-old man with inotrope dependent heart failure was declined for allotransplant and MCS at multiple centers and was transplanted with a 10 gene-edited porcine cardiac xenograft under FDA expanded access Investigational New Drug (eIND) approval. After requiring perioperative transfusions, by post operative day (POD) 13, endomyocardial biopsy revealed antibody and complement deposition without damage or cellular infiltrate. Hemodynamic decompensation on POD 29 prompted biopsy revealing antibody mediated rejection (AMR). The patient required ECMO support POD31 and chose comfort care POD 40.
Research Questions/Hypothesis: The cardiac xenograft doubled in mass from implant to autopsy. Donor derived cell free DNA (cfDNA) correlated temporally with the rejection findings. These processes are hypothesized to correlate.
Approach: Routine TTE measurements of diastolic LV posterior wall dimension (LVPWd), intraventricular septal dimension (IVSd), LV mass, and LV mass index were taken. Donor derived cfDNA was measured weekly and PRN (Care Dx Inc., Brisbane, CA). Pearson correlation coefficient analysis was conducted in GraphPad Prism 10 (Dotmatics, Boston, MA).
Results/Data: POD 26 TTE measurements indicated thickening graft. POD 30 cfDNA began elevating. cfDNA correlated moderately with LVPWd (r = 0.43, p=0.4) and IVSd (r= 0.5, p=0.31) less so with LV mass (r= 0.28, p=0.59) and LV mass index (r=0.34, p=0.51)
Conclusions: Xenograft cardiac thickening measured on TTE preceded elevation in cfDNA. Both were moderately correlated and temporally corresponded to biopsy diagnosed AMR and ultimate graft failure. Future xenograft surveillance will likely benefit from multimodal approach.
  • Tully, Andrew  ( University of Maryland , Baltimore , Maryland , United States )
  • Hong-zohlman, Susie  ( University of Maryland , Baltimore , Maryland , United States )
  • Gupta, Anuj  ( University of Maryland , Baltimore , Maryland , United States )
  • Grazioli, Alison  ( University of Maryland , Baltimore , Maryland , United States )
  • Feller, Erika  ( MedStar , Washington , District of Columbia , United States )
  • Griffith, Bartley  ( University of Maryland , Baltimore , Maryland , United States )
  • Ananthram, Manjula  ( University of Maryland , Baltimore , Maryland , United States )
  • Mohiuddin, Muhammad  ( University of Maryland , Baltimore , Maryland , United States )
  • Galindo, Javier  ( University of Maryland , Baltimore , Maryland , United States )
  • Cipriano, Sarah  ( University of Maryland , Baltimore , Maryland , United States )
  • Saharia, Kapil  ( University of Maryland , Baltimore , Maryland , United States )
  • Lankford, Allison  ( University of Maryland , Baltimore , Maryland , United States )
  • Dickfeld, Timm  ( University of Maryland , Baltimore , Maryland , United States )
  • Asadi, Sadegh  ( University of Maryland , Baltimore , Maryland , United States )
  • Hicks, Albert  ( University of Maryland , Baltimore , Maryland , United States )
  • Author Disclosures:
    Andrew Tully: DO NOT have relevant financial relationships | Susie Hong-Zohlman: DO NOT have relevant financial relationships | Anuj Gupta: DO NOT have relevant financial relationships | Alison Grazioli: No Answer | Erika Feller: No Answer | Bartley Griffith: No Answer | Manjula Ananthram: DO NOT have relevant financial relationships | Muhammad Mohiuddin: DO have relevant financial relationships ; Research Funding (PI or named investigator):United Therapeutics, Inc:Active (exists now) | Javier Galindo: DO NOT have relevant financial relationships | Sarah Cipriano: No Answer | Kapil Saharia: No Answer | Allison Lankford: DO NOT have relevant financial relationships | Timm Dickfeld: No Answer | Sadegh Asadi: DO NOT have relevant financial relationships | Albert Hicks: DO have relevant financial relationships ; Speaker:Boerhinger Ingelheim :Active (exists now) ; Advisor:Abbott:Active (exists now)
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

Heart Transplant: The Next Generation

Saturday, 11/16/2024 , 02:50PM - 04:15PM

Moderated Digital Poster Session

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