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Patients receive heart transplants as a life saving measure after heart failure. Ensuring the success of the transplant is of utmost importance as transplantation is often the last resort for these patients. Rejection is the primary cause for heart transplant failure and consequently, patients must take drugs that suppress their immune system to prevent rejection. Yet there is a fine balance to be achieved in immune system suppression. Too little suppression might lead to rejection of the transplant (both acute and chronic), while too much suppression can cause other serious and life threatening side effects such as infections, kidney problems and even cancer. 

New immunosuppressive drugs to prevent transplant rejection while allowing normal immune function would greatly improve care and patient outcomes. Importantly, this balance is likely to be highly personalized to each individual heart transplant recipient (based on their genetics and other factors). Therefore, there is a great need to develop more effective clinical management tools and tests (for example, using blood-based biomarkers), that can help fine-tune immunosuppression therapy for each individual patient. 

This project builds on many years of measuring the biomarker signatures in blood (gene expression-RNA) donated from hundreds of heart transplant patients. These studies enabled researchers to develop a blood test to monitor for the absence of acute rejection. By accessing the Integrated Health Informatics Datalab (IHID) platform, these biomarker data have been linked with routinely collected electronic health records and statistical analysis of short- and long-term outcomes in the study population (e.g., renal complications and infections) have been completed. Such data linkages were difficult, if not impossible, to carry out within the current healthcare environment. The researchers leveraged these linkages and conducted proof-of-concept experiments where gene expression data were analyzed with respect to common patient outcomes. In the future, these achievements will allow the researchers to carry out a larger study in collaboration with other transplant centres in Canada, in order to develop new biomarker tests to fine-tune immunosuppressive treatments on a patient-by-patient basis, minimizing negative outcomes.