Response by Loupy et al to Letters Regarding Article, “Gene Expression Profiling for the Identification and Classification of Antibody-Mediated Heart Rejection”
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Moajedi et al ask some interesting questions. The present studies, part of INTERHEART (Diagnostic and Therapeutic Applications of Microarrays in Heart Transplantation, a Multicenter Study; ClinicalTrials.gov. Unique identifier: NCT02670408), included indication and protocol biopsies, with consent, as approved by institutional review boards. Serial biopsies to follow changes after treatment were not permitted outside the clinical standard-of-care. However, in continuing studies in heart transplants1 and kidney transplants,2 we have anecdotally seen the resolution of changes of T-cell–mediated rejection (TCMR), and in some cases of antibody-mediated rejection (ABMR), in subsequent standard-of-care biopsies after successful treatment in individual cases. But this protocol does not permit formal examination of the question asked. The current state of ABMR treatment is such that the effectiveness of treatment has not been established in prospective studies. Until we have more effective treatments, it will be difficult to answer your question about the time course of resolution of the …