OPtimal Adult Heart Transplant Immunosuppression With MicroRNA Levels

This study is investigating whether measuring microRNA levels in the blood — tiny molecules that regulate gene expression — can help doctors personalize the immunosuppression (anti-rejection medication) given to adult heart transplant recipients. The goal is to reduce the risk of rejection while also minimizing side effects from too much immunosuppression. **You may be eligible if...** - You are 18 or older - You received a heart transplant within the past month (plus or minus 2 weeks) - You are planning to have follow-up care at the transplant center for at least one year - You are able and willing to follow the study schedule **You may NOT be eligible if...** - You received multiple organ transplants at the same time - You have had a previous solid organ transplant before this heart transplant - You still need a mechanical heart-assist device or are on medications to keep your blood pressure stable - You need dialysis or kidney replacement therapy - You have an active infection or active rejection being treated with IV medications Talk to your doctor to see if this trial is right for you.