Diagnosis of human cardiac allograft rejection by serial cardiac biopsy

Caves, Philip K.; Stinson, Edward B.; Billingham, Margaret E.; Rider, Alan K.; Shumway, Norman E.

doi:10.1016/s0022-5223(19)39805-8

Cited by 151 publications

(18 citation statements)

References 4 publications

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“…EMB is the gold standard for the diagnosis of rejection (8)(9)(10)(11)(12)(13), but significant complications include pericardial effusion, cardiac perforation, tricuspid valve injury, loss of peripheral venous access and arrythmias (14,15). Children are subject to considerable discomfort and inconvenience with EMB.…”

mentioning

confidence: 99%

The use of Doppler tissue imaging to predict cellular and antibody‐mediated rejection in pediatric heart transplant recipients

Behera

Trang

Levi

et al. 2007

Pediatric Transplantation

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DTI indices have been associated with cellular rejection in adult heart transplant recipients, but their predictive value in pediatric recipients is unknown. The purpose of this study was to evaluate DTI measures in the detection of cellular and AMR in pediatric heart transplant recipients. One hundred and forty-eight pediatric heart transplant recipients who had 267 cardiac catheterization procedures with EMB, echocardiogram with DTI, and BNP level performed on the same day were included in the study. For the mitral and tricuspid valves, the ratios (E/E') between the early diastolic inflow velocity by pulsed Doppler (E, m/s) and the early diastolic annular velocity by DTI (E', m/s) were obtained and compared between subjects with and without rejection. Of the 148 recipients, 30 subjects had a total of 37 episodes of rejection: 10 cellular (>or=1B), 17 AMR, and 10 biopsy-negative clinical rejection. Mitral and tricuspid valve E/E' ratios were significantly higher in rejectors than in non-rejectors (5.5 +/- 1.3 vs. 4.4 +/- 1.4, p < 0.001 and 4.9 +/- 2.1 vs. 4.1 +/- 1.5, p < 0.01, respectively). By multivariate linear regression, mitral valve E/E' was an independent predictor of rejection. Mitral and tricuspid valve E/E' <5.0 had 93% and 89% NPV, respectively, for rejection. Mitral and tricuspid valve E/E' ratios <5.0 may be useful non-invasive screening measures to exclude rejection in pediatric heart transplant recipients.

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confidence: 99%

The use of Doppler tissue imaging to predict cellular and antibody‐mediated rejection in pediatric heart transplant recipients

Behera

Trang

Levi

et al. 2007

Pediatric Transplantation

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“…Cardiac rejection is characterized by alterations in microvascular surface antigens, inflammatory cellular infiltration, interstitial hemorrhage, and myocardial edema. 20 This leads to an increase in PWT and LV mass on echocardiography as surrogate markers of allograft rejection. 24,25 Although an increase in PWT was found to be a reproducible measure of cardiac rejection in a mouse model of cardiac transplantation, 7 we were unable to consistently evaluate the PWT in our rat model, likely due to limited spatial resolution.…”

Section: Discussionmentioning

confidence: 99%

“…The Billingham rejection scale was used to assess the status of graft rejection, ranging from 0 (no rejection) to 3 (maximum rejection). 20…”

Section: Histological Examinationmentioning

confidence: 99%

The Role of Tissue Doppler Imaging in the Noninvasive Detection of Chronic Rejection after Heterotopic Cardiac Transplantation in Rats

et al. 2008

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“…5, No. 2,1990 Journal of Cardiac Surgery proximately 2,000 endom yocardial biopsies have been performed necessitating a variety of venous access routes. For venous access we have developed a scheme ( Fig.…”

Section: Methodsmentioning

confidence: 99%

Endomyocardial Biopsy: Variations in Venous Access for Endomyocardial Biopsy in Cardiac Transplantation

et al. 1990

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With the increasing number of cardiac transplantation procedures performed worldwide, a strategy for endomyocardial biopsy techniques has evolved at our institution. Specific approaches for venous access for biopsy purposes are described. These include approaches via the right internal jugular vein, right external jugular vein, left subclavian vein, and the femoral veins. Particular emphasis is placed on the technical nuances of each approach. In approximately 2,000 endomyocardial biopsies performed on 155 transplant patients from 1984-1989, only two major complications occurred, only one of which required operative intervention. This was a perforated right ventricle, and the patient recovered after repair without further sequelae. No pneumothoraces or infection occurred during this time period. With proper understanding of regional anatomy, fluoroscopic appearance, and experience, endomyocardial biopsies can be performed with an extremely low incidence of major or minor complications.

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Diagnosis of human cardiac allograft rejection by serial cardiac biopsy

Cited by 151 publications

References 4 publications

The use of Doppler tissue imaging to predict cellular and antibody‐mediated rejection in pediatric heart transplant recipients

The use of Doppler tissue imaging to predict cellular and antibody‐mediated rejection in pediatric heart transplant recipients

The Role of Tissue Doppler Imaging in the Noninvasive Detection of Chronic Rejection after Heterotopic Cardiac Transplantation in Rats

Endomyocardial Biopsy: Variations in Venous Access for Endomyocardial Biopsy in Cardiac Transplantation

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