Vanderbilt Health researchers use spatial transcriptomics to study heart transplant rejection

Researchers from Vanderbilt Health and the Translational Genomics Research Institute (TGen) have utilized image-based spatial transcriptomics to map cellular programs involved in heart transplant rejection. The study, published in Nature Cardiovascular Research, analyzed longitudinal endomyocardial biopsy samples from 62 adult and pediatric heart transplant recipients.

Allograft rejection affects up to 40% of organ recipients within the first year post-transplant, potentially leading to graft failure or death. Current diagnostic methods rely heavily on tissue histology, which can show significant variability. This variability can lead to imprecise immunosuppressive therapies, resulting in either over- or under-immunosuppression.

The new molecular mapping links cell-specific gene expression patterns to the development of cardiac allograft vasculopathy (CAV), a chronic rejection form that limits long-term survival. The findings aim to improve precision medicine by helping clinicians sharpen diagnoses, predict how patients will respond to antirejection treatments, and better stratify long-term risks.