The Challenge
With every heart transplant, there is always the possibility of rejection. Currently, rejection is diagnosed through invasive methods such as multiple heart biopsies, which are traumatic and only accessible in specialist hospitals. This project aims to transform the diagnosis of cardiac rejection through non-invasive methods, and ultimately improve the management and treatment of heart transplant recipients.
Project Overview
This project extends on a funded clinical trial to optimise and evaluate a non-invasive, cost-effective method for diagnosing cardiac rejection in heart transplant patients using high-field strength MRI to scan the heart, alongside a simple blood test. By investigating the reliability and accuracy of this new method of detection, Professor Andrew Jabbour hopes to replace invasive heart biopsies with a simple, reliable, cost-effective non-invasive technique. There is also potential that this new method could also serve to improve the detection and management of inflammatory heart disease (myocarditis) in the general community.
Supported initially by an Early Mid-Career Researcher Grant and additional funding from St Vincent’s Clinic Research Foundation, the project has advanced through collaborations with the Garvan Institute and Omixon, enhancing testing methods and participant inclusivity.
Project Outcomes
The intended outcome is to lead to better clinical pathways for safe, remote, non-invasive patient monitoring to facilitate better patient management and for health systems to benefit through the cost-effective use of resources.
Measuring Impact
Hearts and Minds measures its impact across six core categories as developed by the Association of Australian Medical Research Institutes. Key highlights include:
Advancing Knowledge
- Collaborations with Garvan Institute: Developing a new blood test for detecting organ rejection post-transplant. This cost-effective test aims to replace current commercially available kits.
- Industry Partnership with Omixon: Supplying materials at cost in exchange for product quality data, enabling more frequent and broader patient checks.
- Global Relevance: Strengthened partnerships with established institutions like the Garvan Institute and international collaborations like a high-volume transplant centre in India have provided the study with valuable insights and resources, enhancing the global relevance of the research.
Research Capacity Building
- Supporting Young Talent: Supporting one early post-graduate researcher, one early-mid post-doctoral researcher, and a new PhD student with experience in managing heart transplant patients.
- Sharing Materials: Developing an internal biobank for genetic materials at the Garvan Institute and internal databases for imaging and clinical data at St Vincent’s Hospital.
Health Impacts
The project aims to:
- Digital Tools: Create an MRI analysis package and a DNA-based screening tool to assist in patient monitoring and data collection.
- Clinical Practice Integration: Development and approval of new diagnostic tools and methods are being integrated into clinical practice.
- Health System Improvements: Streamlined diagnostic processes and improved patient compliance and satisfaction through the use of non-invasive MRI and genetic screening techniques.
- Patient Outcomes: Advancements in non-invasive screening and early detection will improve patient health impacts by reducing the requirement for invasive biopsies and endomyocardial biopsy-related complications.
- Quality-Adjusted Life Years: Non-invasive MRI screening has the potential to improve patient quality-adjusted life years compared to biopsy-based surveillance.
- Scope Extension: This second randomised clinical trial builds on Phase 1, supporting the effectiveness of new diagnostic methods to guide intervention. Plans for larger multi-centre trials and population-level analysis are underway.
Economic Impacts
The program has the potential to:
- Cost Reduction: MRI-based screening reduces the need for invasive biopsies by 94%, saving AUD $32,878.61 per patient and enhancing cumulative Quality-Adjusted Life Years by 0.588 compared to biopsy-based surveillance.
- Innovative Impact: Innovations in heart MRI analysis software are being prepared for broader clinical research applications, with potential licensing of the technology
This project exemplifies the innovative spirit and collaborative efforts necessary to transform cardiac rejection monitoring.
Funding support from Hearts and Minds Investments, as nominated by Core Fund Manager, Magellan.
For further information and updates, visit St Vincent's Clinic Research Foundation. This content was last updated in July 2024.
