A global leader in cell-free DNA and precision medicine, today announced a broad body of evidence supporting its Prospera test at the 2026 International Society for Heart and Lung Transplantation (ISHLT) Annual Meeting.
Prospera will be featured in 17 abstracts, including six oral presentations. Together with academic colleagues, Natera will highlight Prospera’s expanding clinical utility in heart and lung transplantation, spanning rejection surveillance, imaging correlation, and real-world clinical decision-making. Key highlights include:
In heart transplant:
- Prospera Heart serial dynamics (increases/decreases) predicted a variety of adverse outcomes at 1-year post-transplant, in addition to rejection. Patients with a positive Prospera result were up to 4x more likely to experience adverse outcomes by 1-year post-transplant – including graft dysfunction, rejection, hospitalization, or death – and Prospera outperformed biopsy in detecting many of these outcomes. (ProTECT study and DEFINE-HT study)
- Real-world clinical impact: in more than 30% of cases, Prospera results influenced physician decisions related to immunosuppression or biopsy, demonstrating clinical utility beyond just identifying acute rejection. (ProTECT study)
- New independent validation solidifies the excellent performance of Prospera Heart with DQS, preserving high sensitivity while reducing false positives by 30% compared to donor fraction alone. (TRIFECTA-Heart study)
In lung transplant:
- Data from multiple abstracts highlight the ability of Prospera Lung to detect infection, chronic lung allograft dysfunction (CLAD), and early signs of graft damage, including scenarios where such complications were undetected on biopsy. (Abstracts # 1158 and 401)
- While the standard cutoff for a Prospera-positive result is 1%, many studies have shown that significantly increased Prospera results (>2%), defined as extreme molecular injury (EMI), convey even higher risk of CLAD and mortality. New data suggests that a preemptive treatment approach to identify EMI can lead to improved patient outcomes, including forced expiratory volume in 1 second (FEV1). (Abstract #1152)
- Prospera Lung was able to detect gastroesophageal reflux, showing a 77% quantitative decrease after treatment with antireflux surgery, and demonstrating the utility of Prospera as a biomarker for lung allograft injury caused by reflux and microaspiration in addition to rejection. (Abstract #1147)
“ISHLT 2026 marks our largest presence at the conference to date, reflecting the growing body of evidence supporting Prospera in heart and lung transplantation,” said Sangeeta Bhorade, M.D., chief medical officer of organ health at Natera. “What’s especially compelling is not just the breadth of data, but how consistently it reinforces Prospera’s role as a high-precision, clinically actionable tool, enabling earlier detection, more refined risk stratification, and more informed decision-making in transplant care.”
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