Vanderbilt University Medical Center
Acute rejection remains a major cause of morbidity and mortality in pediatric patients after heart transplant. In order to screen for rejection, most centers perform heart catheterizations with endomyocardial biopsies frequently in the first year post transplant and then every 1-2 years thereafter; these biopsies are associated with complications, can cause significant anxiety in patients and family members, and are a significant cost for the healthcare system. This project will evaluate non-invasive methods of detecting rejection using cardiac magnetic resonance imaging and blood testing with a goal to reduce the required number of cardiac catheterizations.
Despite significant advances in the care of pediatric heart transplant (PHTx) patients, acute rejection (AR) remains one of the leading causes of death. Cardiac catheterization with endomyocardial biopsy (biopsy) is the standard of care for diagnosing AR and is performed when there is a clinical suspicion for AR or during routine surveillance. Unfortunately, biopsy is invasive and associated with potential risks, including: complications from anesthesia or sedation, valve damage, injury to the conduction system, vascular damage or occlusion, and cardiac perforation. These potential complicatio…
Inclusion Criteria: * Received heart transplant at age \< 21 years old * \> 2 months from transplant * ≥6 years old and ≤ 25 years old and able to undergo cardiac MRI (CMR) * CMR can be scheduled within 5 days from heart biopsy\* * Heart catheterization with biopsy is scheduled "for cause" to confirm suspected AR or Heart catheterization with biopsy is scheduled for surveillance Exclusion Criteria: * No endomyocardial biopsy scheduled * Other illness or disease process that could potentially lead to myocardial edema or fibrosis * Contraindication to CMR with contrast * Previously enrolled i…