Routine surveillance endomyocardial biopsy: late rejection after heart transplantation.
Ann Thorac Surg
; 64(5): 1231-6, 1997 Nov.
Article
in En
| MEDLINE
| ID: mdl-9386684
ABSTRACT
BACKGROUND:
Transplant programs use routine surveillance endomyocardial biopsies (RSEMB), which are performed at preset intervals to diagnose cardiac rejection. This retrospective study determined the incidence of graft rejection detected by RSEMB.METHODS:
The records of 95 patients who underwent heart transplantation between 1987 and 1995 were reviewed. Rejection incidence was recorded for 80 patients who survived at least 30 days, with a mean follow-up of 35 months.RESULTS:
One thousand five hundred sixteen total biopsies were performed; 1,170 were RSEMB. Four hundred seventy-five total rejection episodes occurred and 269 (56%) were diagnosed by RSEMB. Two distinct patient groups were identified. The majority (70 patients), had a decline in the incidence of rejection and no rejection episodes were identified by RSEMB after 36 months. In contrast, the high rejection group (10 patients) had a significantly higher ongoing rejection rate (p < or = 0.04 to p < or = 0.001) throughout their postoperative course up to 72 months.CONCLUSIONS:
The majority of our transplant patients demonstrate a decrease in rejection with time and do not require RSEMB beyond 30 months. We identified a group of patients who exhibited a higher rate of rejection and need continued RSEMB.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Biopsy, Needle
/
Heart Transplantation
/
Endocardium
/
Graft Rejection
/
Myocardium
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Ann Thorac Surg
Year:
1997
Document type:
Article
Affiliation country:
Estados Unidos