Q&A with Dr Chris Anthony

Dr Chris Anthony received a 2016 Health Professional Scholarship for his research project ‘Cardiovascular Magnetic Resonance for Rejection Surveillance after Cardiac Transplantation’ at Victor Chang Cardiac Research Institute.

Dr Anthony completed his PhD at the Victor Chang Cardiac Research Institute & University of New South Wales, where he was awarded the President’s Prize and Early Career Research Award of the Transplant Society of Australia and New Zealand. His work was also recognised as a finalist for the Ralph Reader Clinical Prize of the Cardiac Society of Australia and New Zealand.

Tell us about your research project?

We conducted a world-first study demonstrating that a new cardiac MRI based ’virtual biopsy’ technique is effective and safe for the screening, detection and treatment of heart transplant rejection in the first-year post-transplant.

What difference will your research make to people’s cardiovascular health in Australia? 

Approximately 100 Australians receive a heart transplant each year. Most transplant recipients experience some form of rejection of the donor heart in the first year of receiving their heart transplant. Rejection contributes to the death of around one in 10 people in that first year.

Accordingly, clinicians around the world screen for rejection by performing at least 10-12 invasive heart biopsies in the first year following transplant. Biopsies help diagnose rejection, guide treatment decisions and allow clinicians to assess the adequacy of response to therapy they have initiated. The downside is that biopsies are invasive, time-consuming, and can cause serious complications. Each biopsy procedure involves a puncture into a vein in the neck or groin, after which a bioptome tool is used to obtain at least five samples of heart tissue for evaluation.

Compared to traditional biopsies, the new virtual biopsy technique our team has developed is non-invasive, takes less time, is more cost-effective, uses no radiation or contrast agents and is much preferred by transplant recipients as they no longer have to endure repeated painful and potentially dangerous invasive biopsies after receiving their heart transplant.

The virtual biopsy is performed using a cardiac MRI-based computer-generated tissue map. This tissue map allows clinicians to assess the degree of inflammation in the heart, where elevated levels are indicative of heart transplant rejection.

The technique significantly reduces the time required to diagnose transplant rejection as the cardiac MRI results can be obtained in 30 minutes. A traditional biopsy result can take up to eight hours from time of sampling to grading by a pathologist.

The virtual biopsy technique also reduced the need for invasive biopsies by at least 94% in our study, resulting in an average cost saving of $16,000 per person per year. This translates to an average saving of up to $500,000 per year to the Australian health system for each individual transplant centre in Australia.

The cardiac MRI technique allows clinicians to evaluate the entire transplanted heart and its surrounding structures and provides them with important information on how well the heart is working. Conversely, the traditional biopsy technique is limited to evaluation of a single site within the heart and provides no information on heart function or its surrounding structures.

What motivated you to do your research? 

The ability to make a small difference in a person’s journey following a heart transplant by reducing the need for repetitive invasive, painful and anxiety-provoking biopsy procedures was profoundly motivating. The development of this technique has been the most rewarding undertaking of my academic career thus far.

Are there any achievements or discoveries from the past year you can share with us? 

Our research was selected as a finalist for the Ralph Reader Prize at the 2020 Cardiac Society of Australia and New Zealand Annual Scientific Meeting and has been published in Circulation, a respected peer reviewed international journal. 

What role has Heart Foundation funding had in your career journey?

My Heart Foundation scholarship was pivotal in providing the means and support to conduct this four-year project, that ultimately led to a world first finding that may change how the transplant community screens for rejection in heart transplant recipients worldwide. This is an important advancement on a technique that has been in use for the last 50 years.

The success of this study will inform future research on the use of a Cardiac MRI based virtual biopsy technique in children who are transplant recipients, who at present require general anaesthesia to undergo screening biopsies after heart transplant. 

Do you have a message for Heart Foundation supporters? 

The team at the Victor Chang Cardiac Research Institute and St Vincent’s Hospital Sydney is in the process of planning a large multi-centre international trial, that aims to demonstrate the effectiveness and safety of the virtual biopsy technique in both adults and children. Ultimately, this may lead to the incorporation of a cardiac MRI-based virtual biopsy strategy for surveillance of heart transplant rejection worldwide.

Our work highlights the importance of the support of the Heart Foundation and their donors in enabling Australian researchers to continue to conduct clinically impactful and ground-breaking research.