Routine Surveillance Endomyocardial Biopsy: Late Rejection After Heart Transplantation

Heimansohn, David; Robison, Robert J.; Paris, John M.; Matheny, Robert G.; Bogdon, JoAnne; Shaar, Carl J.

doi:10.1016/s0003-4975(97)00732-7

Cited by 23 publications

(12 citation statements)

References 6 publications

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“…Moreover, in the present study, proportionally more first-year ACRs ≥ grade 2 were found among EMBs performed during week 16-52 (8.8%) compared with week 1-12 (6.3%). This is in contrast to some previous studies, observing more first-year ACRs in month 0-3 than month 4-12 after HT [10][11][12]. These results may, however, in our cohort, be explained by the reduced frequency of EMBs performed during 16-52 weeks vs. 1-12 weeks after HT, allowing less frequent adjustments of the immunosuppression.…”

Section: Discussioncontrasting

confidence: 99%

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Acute cellular rejection the first year after heart transplantation and its impact on survival: a single-centre retrospective study at Skåne University Hospital in Lund 1988-2010

et al. 2014

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SummaryAcute cellular rejection (ACR) the first year after heart transplantation (HT) and its impact on survival was investigated. All 215 HT patients at our centre 1988-2010, including 219 HTs and 2990 first-year endomyocardial biopsies (EMBs), were studied. 'Routine' EMBs obtained 1,2,3,4,6,8,10,12,16,20,24,32, 40 and 52 weeks after HT, and 'additional clinically indicated' (ACI) EMBs, were graded according to the 1990-ISHLT-WF. The frequency and severity of first-year ACRs was low, with 6.5% of routine EMBs and 14.1% of ACI EMBs showing ACR ≥ grade 2. Proportionally more (P < 0.05) first-year ACRs ≥ grade 2 were found among EMBs in HTs performed during 1988-1999 (9.6%) than 2000-2010 (5.5%), EMBs performed during 16-52 weeks (8.8%) than 1-12 weeks (6.3%) after HT, EMBs in HTs with paediatric (11.3%) than adult (7.1%) donors, and EMBs in sex-mismatched (10.4%) than sex-matched (6.3%) HTs. Five-and ten-year survival was furthermore lower (P < 0.05) among HTs with ≥1 compared with 0 first-year ACRs ≥ grade 3A/ 3B (82% vs. 92% and 69% vs. 82%, respectively). Ten-year survival was 74% compared with 53% in the ISHLT registry. In conclusion, our results indicate that first-year ACRs ≥ grade 3A/3B affect long-term survival. We believe frequent first-year EMBs may allow early ACR detection and continuous immunosuppressive adjustments, preventing low-grade ACRs from progressing to ACRs ≥ grade 3A/3B, thereby improving survival.

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Section: Discussioncontrasting

confidence: 99%

“…As some previous studies have indicated more first-year ACRs in month 0-3 compared with month 4-12 after HT [10][11][12], the proportions of first-year EMBs with ACR ≥ grade 2 were compared between week 1-12 and week 16-52 after HT, corresponding to month 0-3 and 4-12, respectively.…”

Section: Discussionmentioning

confidence: 99%

Acute cellular rejection the first year after heart transplantation and its impact on survival: a single-centre retrospective study at Skåne University Hospital in Lund 1988-2010

et al. 2014

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“…An International Society of Heart and Lung Transplantation (ISHLT) grade of 2R or greater acute cellular rejection on routine endomyocardial biopsy was treated with augmented immunosuppression and intravenous steroids [12,14,15]. Follow-up endomyocardial biopsies were performed at 14 to 21 days in treated cases.…”

Section: Patient Management and Selectionmentioning

confidence: 99%

Suppressive effects of conversion from mycophenolate mofetil to everolimus for the development of cardiac allograft vasculopathy in maintenance of heart transplant recipients

Watanabe

Seguchi

Nishimura

et al. 2016

International Journal of Cardiology

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“…6 The incidence and predictors of late rejection in adult and pediatric heart transplant recipients have been examined in several studies. [7][8][9][10][11][12][13] The results have not been uniform, and there is no consensus on benefits and cost-effectiveness of long-term surveillance endomyocardial biopsy in all patients. 8 -10,14 -17 This study was designed to examine the utility of longterm biopsy surveillance using a large multi-institutional database.…”

mentioning

confidence: 99%

Utility of Long-term Surveillance Endomyocardial Biopsy: A Multi-institutional Analysis

Stehlik

Starling

Movsesian

et al. 2006

The Journal of Heart and Lung Transplantation

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Routine Surveillance Endomyocardial Biopsy: Late Rejection After Heart Transplantation

Cited by 23 publications

References 6 publications

Acute cellular rejection the first year after heart transplantation and its impact on survival: a single-centre retrospective study at Skåne University Hospital in Lund 1988-2010

Acute cellular rejection the first year after heart transplantation and its impact on survival: a single-centre retrospective study at Skåne University Hospital in Lund 1988-2010

Suppressive effects of conversion from mycophenolate mofetil to everolimus for the development of cardiac allograft vasculopathy in maintenance of heart transplant recipients

Utility of Long-term Surveillance Endomyocardial Biopsy: A Multi-institutional Analysis

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