Skip Navigation LinksHome > March 27, 2014 - Volume 97 - Issue 6 > Utility of Gene Expression Profiling Score Variability to Pr...
Transplantation:
doi: 10.1097/01.TP.0000443897.29951.cf
Clinical and Translational Research

Utility of Gene Expression Profiling Score Variability to Predict Clinical Events in Heart Transplant Recipients

Deng, Mario C.1,15,16; Elashoff, Barbara2; Pham, Michael X.3,4; Teuteberg, Jeffrey J.5; Kfoury, Abdallah G.6; Starling, Randall C.7; Cappola, Thomas P.8; Kao, Andrew9; Anderson, Allen S.10; Cotts, William G.11; Ewald, Gregory A.12; Baran, David A.13; Bogaev, Roberta C.14; Shahzad, Khurram15; Hiller, David2; Yee, James2; Valantine, Hannah A.3 ; for the IMAGE Study Group

Open Access
Supplemental Author Material
Collapse Box

Abstract

Background

Gene expression profiling test scores have primarily been used to identify heart transplant recipients who have a low probability of rejection at the time of surveillance testing. We hypothesized that the variability of gene expression profiling test scores within a patient may predict risk of future events of allograft dysfunction or death.

Method

Patients from the IMAGE study with rejection surveillance gene expression profiling tests performed at 1- to 6-month intervals were selected for this cohort study. Gene expression profiling score variability was defined as the standard deviation of an individual’s cumulative test scores. Gene expression profiling ordinal score (range, 0–39), threshold score (binary value=1 if ordinal score ≥34), and score variability were studied in multivariate Cox regression models to predict future clinical events.

Results

Race, age at time of transplantation, and time posttransplantation were significantly associated with future events in the univariate analysis. In the multivariate analyses, gene expression profiling score variability, but not ordinal scores or scores over threshold, was independently associated with future clinical events. The regression coefficient P values were <0.001, 0.46, and 0.773, for gene expression profiling variability, ordinal, and threshold scores, respectively. The hazard ratio for a 1 unit increase in variability was 1.76 (95% CI, 1.4–2.3).

Discussion

The variability of a heart recipient’s gene expression profiling test scores over time may provide prognostic utility. This information is independent of the probability of acute cellular rejection at the time of testing that is rendered from a single ordinal gene-expression profiling test score.

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

Copyright © 2014 by Lippincott Williams & Wilkins

 

 

 

Login

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.