Project Summary
To develop a better and non-invasive approach to clinically manage the medication needs of heart transplant recipients.
What is the issue for NSW?
Current practices for controlling the dosage and levels of immunosuppression medications (in order to treat and minimise potentially dangerous rejection episodes in heart transplant recipients) require frequent invasive heart biopsy procedures to be performed in the first year after transplantation. Biopsy procedures involve deployment of a special catheter via the veins to extract multiple fragments of heart tissue for analysis, on average every two weeks for the first six months after transplantation. This requires access to catheterisation laboratories housing X-ray equipment and large specialised medical teams. MRI imaging is non-invasive, does not emit radiation and does not require specialised hospital infrastructure. To avert the need for biopsy procedures, this study will demonstrate that MRI imaging may be performed safely and cost-effectively in regional and tertiary centres that house MRI systems to manage the immunosuppression needs of patients.
What does the research aim to do and how?
This research aims to assess MRI as a substitute of biopsy procedures for guiding immunosuppression in paediatric and adult heart transplant patients. This will involve validation to assess the reliability of MRI for grading the degree of heart rejection in children. Additionally, this project will conduct a separate randomised-controlled-trial in adults to compare the safety of MRI compared to biopsy procedures. The randomised-controlled-trial surveillance of rejection to manage the patient’s immunosuppression requirements will be performed either by serial biopsy or MRI procedures. This study will assess whether MRI is equivalent to biopsy screening for monitoring and managing recovery after their heart transplantation procedure.