ArticleClinical transplantation2026
Perspectives of Heart Transplant Patients and Providers on Acute Rejection Surveillance: A Mixed-Methods Study.
Article in Clinical transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06414603 (A Comparative Effectiveness Study in Heart Transplant Patients of Rejection Surveillance With Cell-free DNA Versus Endomyocardial Biopsy), which is not on this map. Cited by 2 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Comparative Effectiveness Study in Heart Transplant Patients of Rejection Surveillance With Cell-free DNA Versus Endomyocardial Biopsy (ACES-EMB)
Who cites it
2 citing papers in PubMed.
- Perspectives of Heart Transplant Patients and Providers on Acute Rejection Surveillance: A Mixed-Methods Study.Clinical transplantation · 2026Article
- From rejection to vasculopathy: a review of non-invasive biomarkers in alloimmune responses in heart transplantation.Frontiers in medicine · 2026Review
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- Update of
Authors and funding
10 authors.
Funding
Abstract
backgroundEndomyocardial biopsies (EMB) remain the reference standard for detection of acute rejection in heart transplant (HTx) patients. Recent studies evaluating novel noninvasive tests have sparked a renewed discussion in the HTx community about revising acute rejection surveillance policies. However, patient and provider perspectives remain underexplored. This single-center study examined both HTx patient and provider perspectives on replacing EMBs earlier with noninvasive blood tests.
methodsWe performed semi-structured interviews with 28 HTx patients to explore their perspectives on replacement of EMBs with donor-derived cell-free DNA (dd-cfDNA) early post-HTx. We subsequently conducted a survey of 118 HTx patients using self-administered online questionnaires. We also performed semi-structured interviews with 18 HTx providers to explore their perspectives. Thematic analysis was performed on interview and open-ended survey responses using deductive and inductive approaches. Patient quantitative survey responses were analyzed with descriptive statistics.
resultsOur study identified three key themes: patient anxiety related to EMBs, importance of patient-provider communication, and strong interpersonal trust in providers by HTx patients. Although 78.4% of patients experienced EMB-related anxiety, they prioritized testing accuracy to ensure "the health of their new heart." Consequently, patients favored the most accurate testing protocol and trusted providers to make this decision (91.1%). HTx providers raised concerns about the accuracy and safety of noninvasive surveillance testing for high-risk patients.
conclusionHTx patients trusted their providers to determine the most accurate acute rejection surveillance policy. Additionally, our study provides important patient-centered priorities to guide the implementation of early noninvasive testing into clinical practice.
trial registrationClinicalTrials.gov identifier: NCT06414603.
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