Enduring Hearts- 78Helping Hearts…

Your continued support enables us to meet our research funding goals, which in turn will encourage more investigators to submit their ideas and kick-start the innovation that we need to solve this problem. Unlike most charities, when you contribute your dollars to Enduring Hearts, we are able to turn those dollars into more than a dollar going directly to our cause due to our funding alignments with the American Heart Association (AHA) and the International Society of Heart & Lung Transplantation (ISHLT).

The Enduring Hearts Scientific Advisory Committee has selected the following research efforts since inception:

Emory University – Chimerism of Cardiac Myocytes in Transplanted Heart: This focuses  on the different DNA between  the patient and the transplanted organ. Initial damage is done  to the heart originally by being taken from one body and put into another. You then have two different DNA confusing the immune system. This study is looking at the immune system interaction between  donor and recipient DNA. This project resulted in a paper, which was used to solicit follow‐up funding for a broader study.

University of Toronto  – Immunogenetic  Markers of Extreme Clinical Phenotypes  of Post Transplant Lymphoproliferative  Disorder: PTLD is a form of lymphoma that develops because of the Epstein Barr Virus, the same  virus that causes mononucleosis.  This study looks at markers to determine  which patients would be  at higher  risk of developing  PTLD, and the results would  help in making medication decisions and balancing risk.

Duke University – Prevention of Homograft Induced Cardiac Allograft Vasculopathy in Pediatric Heart Transplantation: A homograph  is a surgical implant due to prior heart surgery. These increase sensitivity, by increasing the recipient’s antibodies and thus decreasing the pool of donor organs. These researchers have found a new protein that could be helpful in desensitization, thereby increasing that pool of donor organs. George explained that the body has so many “checks and balances” that when one part of the immune system is suppressed, another part takes over, so there are many issues to address when dealing with transplants.

Children’s Hospital of Pittsburgh at UPMC – Improving  Late Survival After Pediatric  Heart Transplant Through Improved Understanding of Post‐Tx Myocardial Fibrosis: This study has 2 publications to date. Fibrosis is changes to the heart muscle that make the heart more stiff and rigid, impacting its ability to squeeze. Progression is fairly rapid. This study looks at the relationships  between  cardiac MRI results and biopsy results. The MRI would allow doctors to look at all the myocardium, rather than just one small piece like the biopsy does,  giving a better chance of evaluating and predicting. MRI is less invasive than biopsy, so being able to use that method  would help to improve the quality of life for transplant recipients.

University of Calgary – Validation of a Novel Non‐Invasive Assay for the Detection  of Heart Rejection:  In transplant recipients there is cell‐free  DNA (DNA floating in the bloodstream)  from both the donor and recipient. This study looks at a testing strategy, or assay, to find this floating DNA in the blood and correlate levels of donor DNA with rejection.  This could lead to the use of a blood test, as simple as a finger prick, to predict heart failure and rejection.  This would be less invasive and pose  less risk than a biopsy, again improving the quality of life for transplant recipients.

Vanderbilt University – 2D Speckle Tracking in Echocardiography  for Non‐Invasive  Surveillance of Rejection and Coronary Disease in Pediatric Heart Transplant Recipients: This study is looking at using high‐quality echoes and ultrasounds instead of the current method of biopsies using a catheter to inject dyes into the arteries. This is another possible  option  for less‐invasive methods  of detection,  improving the quality of life for transplant recipients.

University of Chicago  – The Role of Endogenous,  Antigen‐Specific, Auto‐ and Alloreactive T Regs in Transplantation Tolerance: This study has 5 publications to date. The researchers found that they were wrong in their original hypothesis, which looked at T Regs, but they have since found a different protein that seems promising in providing a better understanding of the immune system in order to stop the immune response before  it starts. The results could be used to develop and/or choose better medications.

University of Michigan – Decision Making in Adolescents and Young Adults Pre and Post Heart Transplantation: Medication  compliance  is a tough issue with adolescents, and non‐compliance causes the likelihood of graft failure to increase exponentially. This study looks at the psychosocial medicine behaviors in adolescents, to understand the reasons for non‐compliance and thus improve education understanding, and increase medication compliance.

Columbia  University – Contribution of Innate‐Like B Cells to Human Cardiac Allograft Vasculopathy: B‐Cells infiltrate the cardiac wall. The purpose of this study is to understand how the disease process works in order to start knowing how to treat or prevent it.

University of Illinois – Chicago – Novel Tolerogenic  CD34/MSC Di‐Chimeric Cell Therapy in Vascularized Composite  Allograft and Heart Transplantation: Scientists have been  able to fuse donor and recipient bone marrow cells outside of the body,  but it is rather toxic. They are trying to find a stable method  that can be tested in‐animal to determine the body’s tolerance. If they are able to fuse donor and recipient cells in a stable fashion, this could decrease the need for long‐term immunosuppression.

Cleveland Clinic Foundation – Mechanisms of T Cell Reconstitution Following Antibody‐Mediated Lymphoablation: There are T Cells that are memory cells. These cells remember  previous infections and the immune response to them in order to attack the same infection more quickly and easily in the future. This study looks at suppressing these cells to decrease the immune response, thus decreasing the possibility of rejection.

Every six months, the Enduring Hearts Scientific Advisory Committee evaluates new innovative ideas from researchers around the world. We will continue to seek opportunities to further the mission of significantly increasing both the life-expectancy and quality of life of a heart transplant recipient. We anticipate a growing number of high-quality submissions through our alignment with AHA and ISHLT, as well as through the Enduring Hearts direct granting program. With your support, which is further amplified by matching contributions from AHA and ISHLT, Enduring Hearts will continue to grow the level of funding that we provide to this very important area of research and save thousands of lives in the process.