Established over 40 years ago, our heart transplantation program is the largest and most experienced program in the United States. Our doctors continuously pursue innovative treatment protocols, including treatment for high-risk and multi-organ (heart-lung, heart-liver, and heart-kidney) transplant populations.
Heart Failure Research Institute
Advancing the understanding, prevention, and treatment of heart failure through research
Heart Transplantation
Research Highlights
Donor-derived cell-free DNA
- This research focuses on enhancing monitoring for heart transplant rejection through the use of a non-invasive biomarker (donor-derived cell-free DNA) to measure small amounts of cellular damage. This biomarker can detect rejection much earlier in the course, prior to the development of clinical symptoms, along with other biomarkers including peripheral Gene Expression Profiling. The research aims to:
- Identify the accuracy of donor-derived cell-free DNA for diagnosing rejection in comparison to the gold standard of biopsy and pathological analysis
- Evaluate the additive benefit of gene expression profiling to the results of donor-derived cell-free DNA
- Measure the prognostic value of donor-derived cell-free DNA for long-term patient and graft survival
- Examine the association of donor-derived cell-free DNA with the development of complications related to transplantation, including the development of donor-specific antibodies and cardiac allograft vasculopathy
- The significance of this research is its potential to shift rejection surveillance in heart transplantation from invasive testing (biopsies) to a non-invasive, reliable alternative. This could lead to earlier detection of rejection and improved patient care.
MMDx (Molecular Microscope)
- Molecular microscope is a novel tool that uses gene expression measured on heart biopsy specimens to detect signals for rejection
- This research investigates the clinical effectiveness of molecular microscope testing when used as an adjunct to current methods to detect rejection, including biomarkers (donor-derived cell-free DNA), donor-specific antibodies, and traditional histological analysis of biopsy specimens
- We are exploring how molecular microscope testing may provide additional information that can change therapeutic decision-making. We are also analyzing changes in molecular microscope signals following specific therapies.
- We are further assessing the long-term prognosis of specific molecular microscope results to better understand the test’s clinical significance
- The importance of this research is that the accuracy of histological analysis of biopsies, currently the gold standard, has come into question due to the frequency of clinical signs of rejection with negative biopsy results. Molecular microscope may offer additional information that can supplement traditional methods for determining rejection and improve our ability to detect rejection early, prior to significant myocardial damage.
Belatacept (BTC)
- Belatacept is a novel immunosuppression agent that has a different side-effect profile than the agents traditionally used to prevent rejection in heart transplantation. A noted benefit of belatacept is its neutral effect on kidney function, in comparison to the renal toxicity that is common with calcineurin inhibitors.
- Belatacept has been improved for use in kidney transplantation, but data about its efficacy and safety in heart transplantation are limited
- This research aims to establish the benefits and risks of belatacept use in heart transplantation through the examination of our center’s experience
Letermovir
- Letermovir is an antiviral medication that has specificity for cytomegalovirus (CMV). Due to its low side effect profile, letermovir may have advantages over valganciclovir, which is commonly used to prevent CMV infection in solid organ transplantation. Specifically, valganciclovir therapy may be limited by bone marrow suppression, which has not been seen with letermovir.
- This research aims to establish the efficacy and safety of letermovir in a heart transplant population
Recent publications
Efficacy and safety of belatacept in heart transplant recipients
Baranowska J, Oren D, Valledor AF, Uriel M, Lee C, Moeller CM, Elad B, Rahman S, Hertz A, Skoll D, Regan M, DeFilippis EM, Raikhelkar J, Fried J, Lotan D, Oh KT, Bae D, Rahman A, Choe J, Clerkin K, Yunis AA, Yuzefpolskaya M, Colombo PC, Majure D, Latif F, Sayer G, Uriel N. Efficacy and safety of belatacept in heart transplant recipients. J Heart Lung Transplant. 2025 Oct;44(10):1612-1620. doi: 10.1016/j.healun.2025.04.023. Epub 2025 May 28. PMID: 40446881.
Lang FM, Liu J, Clerkin KJ, Driggin EA, Einstein AJ, Sayer GT, Takeda K, Uriel N, Summers RM, Topkara VK. Sarcopenia Assessment Using Fully Automated Deep Learning Predicts Cardiac Allograft Survival in Heart Transplant Recipients. Circ Heart Fail. 2025 Oct;18(10):e012805. doi: 10.1161/CIRCHEARTFAILURE.125.012805. Epub 2025 Aug 20. PMID: 40832698.
Rubinstein G, Valledor AF, Moeller CM, Baranowska J, Oren D, Oh DKT, Bae D, Yunis A, Lotan D, Rahman A, Raikhelkar JK, Fried JA, DeFilippis EM, Clerkin KJ, Latif F, Sayer GT, Uriel N. Extracorporeal Photopheresis in the Treatment of Cardiac Allograft Rejection in the Modern Era: A Single-Center Experience. Clin Transplant. 2025 Aug;39(8):e70247. doi: 10.1111/ctr.70247. PMID: 40698560.
Screening and Surveillance for Colorectal Cancer Before and After Heart Transplantation
Abrams ME, Keller E, Lemos C, Regan M, O'Connell DC, Salgado SM, Donald E, Salazar R, Hennecken C, Raikhelkar JK, Latif F, Clerkin KJ, Sayer G, Uriel N, DeFilippis EM. Screening and Surveillance for Colorectal Cancer Before and After Heart Transplantation. Clin Transplant. 2025 Sep;39(9):e70301. doi: 10.1111/ctr.70301. PMID: 40965853.
Valledor AF, Moeller CM, Oren D, Baranowska J, Rahman S, Hertz A, Rahman A, Hennecken C, Rubinstein G, Elad B, Richter I, Lotan D, Regan M, LaBarre B, Yunis A, Fried J, DeFilippis EM, Colombo PC, Yuzefpolskaya M, Raihkelkar J, Latif F, Clerkin KD, Majure DT, Sayer GT, Uriel N. Correlation between donor-derived cell-free DNA and tissue gene expression in heart transplant patients undergoing for-cause endomyocardial biopsies. J Heart Lung Transplant. 2025 Sep;44(9):1384-1393. doi: 10.1016/j.healun.2025.04.019. Epub 2025 May 13. PMID: 40374050.
Outcomes After Heart Transplantation Among Non-Native English-Speaking Recipients
Vargas F, Batra J, Lemos C, Magun E, Salazar RA, Taylor CN, Donald EM, Driggin E, Regan M, McArthur-Murphy R, Lumish H, Concha D, Chung A, Golob S, Latif F, Clerkin KJ, Takeda K, Sayer G, Uriel N, Defilippis EM. Outcomes After Heart Transplantation Among Non-Native English-Speaking Recipients. J Card Fail. 2025 Oct;31(10):1534-1543. doi: 10.1016/j.cardfail.2024.12.010. Epub 2025 Jan 20. PMID: 39842708.
Moeller CM, Valledor AF, Oren D, Rahman S, Rahman A, Regan M, Lee C, Hertz A, Rubinstein G, Baranowska J, Elad B, Hennecken C, Salazar R, Oren A, Donald EM, Lotan D, Oh KT, Bae D, Yunis A, Majure D, Yuzefpolskaya M, Colombo PC, Raikhelkar JK, Fried JA, DeFilippis EM, Takeda K, Clerkin KJ, Latif F, Sayer GT, Uriel N. Clinical Utility of Combined Donor-Derived Cell-Free DNA and Peripheral Gene-Expression-Profiling in Heart Transplant Recipients. Clin Transplant. 2025 Oct;39(10):e70340. doi: 10.1111/ctr.70340. PMID: 41085484.
Impact of Donor and Recipient Sex-Mismatch in Donation After Circulatory Death Heart Transplant
Rajesh K, Feng I, Latif F, Sayer G, Uriel N, Kaku Y, Naka Y, Kurlansky P, Takeda K. Impact of Donor and Recipient Sex-Mismatch in Donation After Circulatory Death Heart Transplant. Clin Transplant. 2025 Sep;39(9):e70285. doi: 10.1111/ctr.70285. PMID: 40891331.
Moeller CM, Fernandez Valledor A, Oren D, Rahman S, Baranowska J, Hertz A, DeFilippis EM, Lee C, Regan M, Oren A, Rahman A, Hennecken C, Salazar R, Donald EM, Lotan D, Majure D, Yuzefpolskaya M, Colombo PC, Raikhelkar JK, Fried JA, Clerkin KJ, Latif F, Sayer GT, Uriel N. Significance of Elevated Donor-Derived Cell-Free DNA in Heart Transplant Recipients With Negative Endomyocardial Biopsies: A Dawn of a New Era. Circ Heart Fail. 2025 Sep 30:e012787. doi: 10.1161/CIRCHEARTFAILURE.125.012787. Epub ahead of print. PMID: 41025234.
Donald EM, Batra J, DeFilippis EM, Raikhelkar JK, Lotan D, Clerkin KJ, Sayer G, Uriel N. Comparable short-term survival in dual organ heart transplant recipients with and without HIV: A call for increased access to organ donation for people living with HIV. Am J Transplant. 2025 Sep;25(9):1996-2007. doi: 10.1016/j.ajt.2025.05.004. Epub 2025 May 7. PMID: 40345498.
DeFilippis EM, Masotti M, Donald EM, Eichler J, Ramu B, Watt T, Mulvihill MS, Takeda K, Uriel N, Cogswell R. Sex Differences in Utilization of Donation After Circulatory Death Donors for Heart Transplantation and Associated Outcomes. Circ Heart Fail. 2025 Aug;18(8):e012835. doi: 10.1161/CIRCHEARTFAILURE.125.012835. Epub 2025 Jun 26. PMID: 40567220.
Orlando EH, Gould P, Cuzzo B, Ford M, Chen Y, Sanjurjo A, Jain S, May B, Tsapepas D, Leeman-Neill RJ, Bhagat G, Dube GK, Morris H, Arcasoy S, Latif F, DeFilippis EM, Martinez M, Im GY, Phipps MM, Pereira MR, Sue PK, Orjuela-Grimm M, Lipsky AH, Sawas A, Reshef R, Pro B, Cherng HJ, Amengual JE. Posttransplant rituximab exposure and risk of PTLD in solid organ transplant recipients with EBV DNAemia. Blood Neoplasia. 2025 Aug 19;2(4):100160. doi: 10.1016/j.bneo.2025.100160. PMID: 41127866; PMCID: PMC12538014.
Feher A, Alwan M, Wright CX, Clerkin KJ, Einstein AJ, Miller EJ, Al-Mallah MH. Surveillance Patterns for Allograft Vasculopathy in Heart Transplant Recipients in PET Myocardial Perfusion Imaging Performing Centers in the United States. JACC Heart Fail. 2025 Oct 14:102718. doi: 10.1016/j.jchf.2025.102718. Epub ahead of print. PMID: 41099687.
