New publication in The Journal of Heart and Lung Transplantation!

Two thresholds are better than one for detecting heart transplant rejection using dd-cfDNA

New in JHLT: a two-threshold algorithm (2TA) combining dd-cfDNA% and donor-quantity score (DQS) outperforms the traditional single-cutoff approach for detecting molecular rejection.

In 366 biopsy-matched samples from the Trifecta-Heart study, benchmarked against MMDx molecular assessment:

🔹 83.7% specificity (vs 76.7% for the old cutoff), similar sensitivity (~83%)
🔹 30% fewer false positives, AUC of 0.87
🔹 2TA detects molecular rejection better than histologic rejection

🔹Incremental increases in both dd-cfDNA% and DQS raised the odds of MMDx rejection.

In short, adding DQS to dd-cfDNA% meaningfully refines noninvasive rejection detection.

📖 Read more here: https://www.jhltonline.org/article/S1053-2498(26)01953-4/fulltext