Prospera™ Evidence in Heart and Lung Transplantation Featured Across 17 Presentations at ISHLT

Key Terms

dd-cfDNA medical

Donor-derived cell-free DNA (dd-cfDNA) are tiny fragments of DNA from a transplanted organ that float in the blood of the recipient; testing measures how much of the free DNA comes from the donor. Like finding fresh crumbs that reveal whether something has been disturbed, higher levels can indicate organ injury or rejection before symptoms appear, so investors watch adoption of these noninvasive tests because they can change follow-up care, reduce costly biopsies, and drive demand for new diagnostics and monitoring services.

donor-derived cell-free DNA medical

Donor-derived cell-free DNA is fragments of DNA shed by a transplanted organ into the recipient’s bloodstream. Measuring its level is like checking a smoke alarm: rising amounts can warn of organ injury or immune rejection before symptoms appear. Investors track this biomarker because tests and treatments that detect or lower it can change clinical decisions, demand for diagnostic services, and the economic outlook for transplant-related healthcare products.

endomyocardial biopsy medical

An endomyocardial biopsy is a medical procedure that removes a tiny piece of heart muscle through a thin tube threaded into a blood vessel so doctors can examine it under a microscope. For investors, it matters because biopsy results can determine the success of drug or device trials, influence regulatory decisions and safety labeling, and affect costs and market demand for therapies tied to heart disease — like taking a small core sample to judge the health and future of an entire structure.

chronic lung allograft dysfunction medical

Chronic lung allograft dysfunction (CLAD) is a long-term decline in lung function that can occur after a lung transplant, caused by scarring, inflammation or immune-related injury to the donated lung. It matters to investors because it drives demand for drugs, diagnostics, devices and follow-up care, influences trial readouts and regulatory decisions, and can create sustained healthcare costs and market opportunities — like a repaired car that slowly loses performance and needs ongoing costly maintenance.

forced expiratory volume in 1 second medical

Forced expiratory volume in 1 second (FEV1) measures how much air a person can forcefully exhale in the first second after a deep breath. Think of it like timing how fast water comes out of a hose when you open it fully; a higher FEV1 means clearer airways. Investors watch it because changes in FEV1 are a common, objective measure of whether respiratory drugs or devices work, which affects clinical success, regulatory approval and market potential.

gastroesophageal reflux medical

Stomach acid and sometimes food flow back up into the tube connecting the mouth and stomach, causing heartburn, throat irritation and potential damage to the lining. For investors it matters because chronic or severe cases drive demand for medicines, devices and procedures, influence clinical trial outcomes and regulatory reviews, and can affect healthcare costs and sales forecasts—like a widespread consumer nuisance that creates predictable markets and regulatory risks.

pet myocardial perfusion imaging medical

PET myocardial perfusion imaging is a medical scan that uses a small amount of radioactive tracer and a positron emission camera to show how well blood flows through the heart muscle. For investors, it matters because the test helps doctors decide whether patients need procedures or long‑term treatment, which influences demand for imaging equipment, hospital services, drugs, and reimbursement rates—similar to how a weather map guides where to send resources.

molecular microscope medical

A molecular microscope is an advanced imaging tool that reveals the shapes and arrangements of individual molecules or tiny biological structures, like a camera with extreme zoom that shows the building blocks of life. For investors, it matters because the instrument speeds drug discovery, product development and quality control, which can boost the commercial prospects of biotech and life-science companies and affect makers of the equipment and their customers.

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Broad evidence, including six oral presentations, highlights Prospera’s ability to enable earlier detection, refine risk stratification, and inform clinical decision-making in transplant care

AUSTIN, Texas--(BUSINESS WIRE)-- Natera, Inc. (NASDAQ: NTRA), 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.”

The full list of presentations at ISHLT includes:

April 22, 6:00 PM ET | Abstract #764
Presenter: Amir Emtiazjoo, M.D., MSc
Lung Transplantation Outcomes in Patients with Respiratory Failure Related to BIPF Following Treatment for Malignancy

April 23, 4:30 PM ET | Abstract #902
Presenter: Shelley Hall, M.D.
Association of Donor Derived-Cell Free DNA with 1-Year Outcomes in Heart Transplant Recipients: Findings from the ProTECT Study

April 23, 4:30 PM ET | Abstract #867
Presenter: Brent C. Lampert, D.O.
dd-cfDNA Informs Clinical Decision-Making in Heart Transplantation: Insights from the ProTECT Study

April 23, 4:30 PM ET | Abstract #868
Presenter: Palak Shah, M.D., M.S.
A Randomized Study of Rejection Surveillance with dd-cfDNA versus Endomyocardial Biopsy (ACES-EMB)

April 23, 4:30 PM ET | Abstract #921
Data from the Trifecta-Heart Study
Presenter: Martina Mackova, Ph.D.
Assessing Early Antibody-Mediated Rejection (AMR) Using MMDx, dd-cfDNA, and Histology

April 23, 4:30 PM ET | Abstract #916
Presenter: Roopa A. Rao, M.D.
Trend of Donor-Derived Cell-Free DNA and DNA Quantity Score in Response to Rejection Treatment in Heart Transplant Recipients

April 23, 4:30 PM ET | Abstract #1001
Presenter: Paul J. Kim, M.D., MAS
Dissecting Clinically Discordant dd-cfDNA Elevations After Heart Transplantation: Insights from the DEFINE-HT Study

April 23, 4:30 PM ET | Abstract #1158
Presenter: Ambalavanan Arunachalam, M.D., M.S.
Donor-Derived Cell-Free DNA Predicts Abnormal Findings on Chest Computed Tomography (CT) Imaging Post-Lung Transplantation

April 23, 4:30 PM ET | Abstract #1157
Presenter: Selim M. Arcasoy, M.D., MPH
dd-cfDNA May Be Discordant with Cellular Profiles in BALF After Lung Transplantation (LT): A LAMBDA Study Analysis

April 23, 4:30 PM ET | Abstract #1152
Presenter: Chang (Jason) Li, M.D.
Preemptive Treatment of 'Molecular Injury' Assessed by Donor-Derived Cell-Free DNA After Lung Transplant

April 23, 4:30 PM ET | Abstract #1147
Presenter: Samir Sultan, D.O., M.S.
Lung Allograft Injury Improves After Gastroesophageal Reflux Surgery According to Donor-Derived Cell-Free DNA

April 24, 10:00 AM ET | Abstract #150 (Oral Presentation)
Presenter: Attila Feher, M.D., Ph.D.,
Correlation Between Donor Derived Cell Free DNA and Cardiac Allograft Vasculopathy Detected by PET Myocardial Perfusion Imaging: Minidepict Study

April 24, 4:30 PM ET | Abstract #401 (Mini Oral Presentation)
Presenter: Majd Alkhouri, M.D.
Donor-Derived Cell-Free DNA for Detection of Infection and Rejection After Lung Transplantation

April 24, 4:30 PM ET | Abstract #402 (Mini Oral Presentation)
Presenter: Eric Morrell, M.D.
Distinct Alveolar and Plasma Molecular Injury Profiles Between Acute Allograft Injuries

April 24, 4:30 PM ET | Abstract #420 (Mini Oral Presentation)
Data from the Trifecta-Heart Study
Presenter: Phillip F. Halloran, M.D., Ph.D.
Validation of a Two-Threshold Algorithm (2TA) Combining dd-cfDNA Fraction and Quantity to Detect Heart Transplant Rejection

April 24, 4:30 PM ET | Abstract #424 (Mini Oral Presentation)
Data from the Trifecta-Heart Study
Presenter: Katelynn S. Madill-Thomsen, Ph.D.
Molecular Microscope® (MMDx) and dd-cfDNA versus Histology for the Diagnosis of Heart Allograft Rejection

April 24, 4:30 PM ET | Abstract #425 (Mini Oral Presentation)
Data from the ProTECT Study
Presenter: Roopa A. Rao, M.D.
Outcomes in Heart Transplant Recipients with Extreme Elevations in Donor Derived Cell-Free DNA %

About Natera

Natera™ is a global leader in cell-free DNA and precision medicine, dedicated to oncology, women’s health, and organ health. We aim to make personalized genetic testing and diagnostics part of the standard-of-care to protect health and inform earlier, more targeted interventions that help lead to longer, healthier lives. Natera’s tests are supported by more than 400 peer-reviewed publications that demonstrate excellent performance. Natera operates ISO 13485-certified and CAP-accredited laboratories certified under the Clinical Laboratory Improvement Amendments (CLIA) in Austin, Texas, and San Carlos, California, and through Foresight Diagnostics, its subsidiary, operates an ISO 27001-certified and CAP-accredited laboratory certified under CLIA in Boulder, Colorado. For more information, visit www.natera.com.

Forward-Looking Statements

All statements other than statements of historical facts contained in this press release are forward-looking statements and are not a representation that Natera’s plans, estimates, or expectations will be achieved. These forward-looking statements represent Natera’s expectations as of the date of this press release, and Natera disclaims any obligation to update the forward-looking statements. These forward-looking statements are subject to known and unknown risks and uncertainties that may cause actual results to differ materially, including with respect to whether the results of clinical or other studies will support the use of our product offerings, the impact of results of such studies, our expectations of the reliability, accuracy, and performance of our tests, or of the benefits of our tests and product offerings to patients, providers, and payers. Additional risks and uncertainties are discussed in greater detail in "Risk Factors" in Natera’s recent filings on Forms 10-K and 10-Q, and in other filings Natera makes with the SEC from time to time. These documents are available at www.natera.com/investors and www.sec.gov.

View source version on businesswire.com: https://www.businesswire.com/news/home/20260422144265/en/

Investor Relations: Mike Brophy, CFO, Natera, Inc., investor@natera.com
Media: Lesley Bogdanow, VP of Corporate Communications, Natera, Inc., pr@natera.com

Source: Natera, Inc.