Hausen, B; Rohde, R; Demertzis, S; Albes, J M; Wahlers, T; Schäfers, H J (1995). Strategies for routine biopsies in heart transplantation based on 8-year results with more than 13,000 biopsies. European journal of cardio-thoracic surgery, 10(9), pp. 592-8. Oxford: Oxford University Press 10.1016/S1010-7940(05)80012-0
|
Text
9-10-592.pdf - Published Version Available under License Publisher holds Copyright. Download (772kB) | Preview |
The endomyocardial biopsy (EMB) in heart transplant recipients has been considered the "gold standard" for diagnosis of graft rejection (REJ). The purpose of this retrospective study is to develop long-term strategies (frequency and postoperative duration of EMB) for REJ monitoring. Between 1985 and 1992, 346 patients (mean age 44.5 years, female patients = 14%) received 382 heart grafts. For graft surveillance EMBs were performed according to a fixed schedule depending on postoperative day and the results of previous biopsies. In the first year the average number (no.) of EMBs/patient was 20 with 19% positive for REJ in the first quarter, dropping to 7% REJ/EMB by the end of the first year. The percentage of REJ/EMB declined annually from 4.7% to 4.5%, 2.2% and less than 1% after the fifth year. Individual biopsy results in the first 3 postoperative months had little predictive value. Patients with fewer than two REJ (group 1), vs patients with two or more REJ in the first 6 postoperative months (group 2), were significantly less likely to reject in the second half of the first year (group 1: 0.29 +/- 0.6 REJ/patient; group 2:0.83 +/- 1.3 REJ/patient; P < 0.001) and third postoperative year (group 1:0.12 +/- 0.33 REJ/patients; group 2:0.46 +/- 0.93 REJ/patient; P < 0.05). In conclusion, routine EMBs in the first 3 postoperative months have only limited predictive value, however the number of routine EMBs can be drastically reduced later depending on the intermediate postoperative REJ pattern.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Faculty Institutions > Teaching Staff, Faculty of Medicine |
UniBE Contributor: |
Demertzis, Stefanos |
ISSN: |
1010-7940 |
ISBN: |
8562106 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Factscience Import |
Date Deposited: |
04 Oct 2013 15:08 |
Last Modified: |
08 Dec 2022 16:03 |
Publisher DOI: |
10.1016/S1010-7940(05)80012-0 |
PubMed ID: |
8562106 |
Web of Science ID: |
A1995TC57700015 |
BORIS DOI: |
10.48350/29690 |
URI: |
https://boris.unibe.ch/id/eprint/29690 (FactScience: 157848) |
Actions (login required)
 |
Edit item |