Natera Announces Completion of Enrollment in Randomized ACES-EMB Trial in Heart Transplantation
January 30, 2026 – Biotechnology, Clinical Trials, Drug Discovery, Other, Pharmaceutical – Natera, cardiology, cell-free DNA, clinical trials, diagnostics, precision medicine
ACES-EMB is the first randomized-controlled trial to compare dd-cfDNA surveillance to routine biopsy in organ transplantation, highlighting the benefits of Prospera in organ rejection
28 January 2026 — Texas, US — Natera, Inc, a global leader in cell-free DNA and precision medicine, today announced the completion of enrollment in ACES-EMB, the first randomized-controlled trial evaluating whether Natera’s Prospera Heart test can replace routine invasive biopsies for rejection monitoring in heart transplant recipients.
Positive results would support a fundamental shift in the standard of care for heart transplant recipients away from invasive tissue sampling to non-invasive molecular monitoring for the approximately 4,500 heart transplants performed annually in the United States. Biopsy procedures are costly, error-prone and put patients at risk of related complications.
EMB is the current standard of care for post-transplant rejection surveillance but requires repeated invasive procedures. ACES-EMB is designed to assess whether molecular surveillance using a non-invasive donor-derived cell-free DNA (dd-cfDNA)-based approach with Natera’s Prospera test can provide comparable clinical outcomes, and potentially reduce reliance on routine biopsies.
ACES-EMB enrolled more than 300 patients across 17 U.S. transplant centers. Patients were randomized at one month after transplant to either surveillance with the Prospera test or standard EMB-based care, and they will be followed for 12 months.
“ACES-EMB is a novel clinical trial in heart transplantation that could support the replacement of invasive, risky and expensive biopsy procedures with a simple blood test,” said Palak Shah, M.D., M.S., Inova Schar Heart and Vascular, and principal investigator for ACES-EMB. “This trial could fundamentally change the way we care for our patients, demonstrating the potential of dd-cfDNA testing as the surveillance modality of choice after transplant.”
“Completion of enrollment in ACES-EMB marks an important milestone toward generating the level of evidence needed to inform changes in heart transplantation,” said Sangeeta Bhorade, M.D., chief medical officer of organ health at Natera. “By directly comparing dd-cfDNA surveillance to biopsy-based care in a randomized setting, we aim to show the clear benefits of non-invasive testing with Prospera.”
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 350 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.
