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Yield of surveillance transbronchial biopsies performed beyond two years after lung transplantation.
J Heart Lung Transplant. 1996 Apr; 15(4):384-8.JH

Abstract

BACKGROUND

Acute lung rejection after transplantation may lead to significant graft dysfunction. Hence surveillance protocols which include transbronchial biopsies have been established to monitor for early findings suggestive of acute rejection. However, the frequency of acute rejection diminishes as time from the transplant procedure increases. We therefore sought to examine the incidence of acute rejection seen on surveillance transbronchial biopsy performed at least 2 years after transplantation.

METHODS

A retrospective review of all transbronchial biopsy was conducted. Forced expiratory volume in 1 second at the time of transbronchial biopsy and in the preceding 6 months was recorded.

RESULTS

A total of 102 transbronchial biopsy procedures were assessed. Histologic evidence of at least grade 2 rejection (including three judged as grade 1 to 2) occurred in biopsy samples from 10 procedures (9.8%). Five of the episodes occurred at 2 years, three occurred at 3 years, and two occurred at 4 years. Inadequate biopsies occurred on 22 occasions (21.6%). A corresponding significant change in forced expiratory volume in 1 second (>or= 10% decline) compared with the preceding 6 months was seen in 4 of 10 episodes of grade 2 acute rejection. Only one of five episodes occurring at least 3 years after transplantation was associated with a decline in forced expiratory volume in 1 second. No evidence of acute rejection was found in any of 15 transbronchial biopsy procedures beyond 4 years after transplantation where adequate material for histologic interpretation was obtained. However, no statistically significant change was found in the proportion of transbronchial biopsy procedures showing acute rejection as a function of time.

CONCLUSIONS

We conclude that transbronchial biopsy-proven acute rejection may occur in patients with asymptomatic, stable conditions who have survived at least 2 years, but the yield of transbronchial biopsy performed beyond 4 years is exceedingly low.

Authors+Show Affiliations

Department of Medicine, Toronto Hospital, Ontario, Canada.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8732597

Citation

Kesten, S, et al. "Yield of Surveillance Transbronchial Biopsies Performed Beyond Two Years After Lung Transplantation." The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, vol. 15, no. 4, 1996, pp. 384-8.
Kesten S, Chamberlain D, Maurer J. Yield of surveillance transbronchial biopsies performed beyond two years after lung transplantation. J Heart Lung Transplant. 1996;15(4):384-8.
Kesten, S., Chamberlain, D., & Maurer, J. (1996). Yield of surveillance transbronchial biopsies performed beyond two years after lung transplantation. The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, 15(4), 384-8.
Kesten S, Chamberlain D, Maurer J. Yield of Surveillance Transbronchial Biopsies Performed Beyond Two Years After Lung Transplantation. J Heart Lung Transplant. 1996;15(4):384-8. PubMed PMID: 8732597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Yield of surveillance transbronchial biopsies performed beyond two years after lung transplantation. AU - Kesten,S, AU - Chamberlain,D, AU - Maurer,J, PY - 1996/4/1/pubmed PY - 1996/4/1/medline PY - 1996/4/1/entrez SP - 384 EP - 8 JF - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JO - J. Heart Lung Transplant. VL - 15 IS - 4 N2 - BACKGROUND: Acute lung rejection after transplantation may lead to significant graft dysfunction. Hence surveillance protocols which include transbronchial biopsies have been established to monitor for early findings suggestive of acute rejection. However, the frequency of acute rejection diminishes as time from the transplant procedure increases. We therefore sought to examine the incidence of acute rejection seen on surveillance transbronchial biopsy performed at least 2 years after transplantation. METHODS: A retrospective review of all transbronchial biopsy was conducted. Forced expiratory volume in 1 second at the time of transbronchial biopsy and in the preceding 6 months was recorded. RESULTS: A total of 102 transbronchial biopsy procedures were assessed. Histologic evidence of at least grade 2 rejection (including three judged as grade 1 to 2) occurred in biopsy samples from 10 procedures (9.8%). Five of the episodes occurred at 2 years, three occurred at 3 years, and two occurred at 4 years. Inadequate biopsies occurred on 22 occasions (21.6%). A corresponding significant change in forced expiratory volume in 1 second (>or= 10% decline) compared with the preceding 6 months was seen in 4 of 10 episodes of grade 2 acute rejection. Only one of five episodes occurring at least 3 years after transplantation was associated with a decline in forced expiratory volume in 1 second. No evidence of acute rejection was found in any of 15 transbronchial biopsy procedures beyond 4 years after transplantation where adequate material for histologic interpretation was obtained. However, no statistically significant change was found in the proportion of transbronchial biopsy procedures showing acute rejection as a function of time. CONCLUSIONS: We conclude that transbronchial biopsy-proven acute rejection may occur in patients with asymptomatic, stable conditions who have survived at least 2 years, but the yield of transbronchial biopsy performed beyond 4 years is exceedingly low. SN - 1053-2498 UR - https://www.unboundmedicine.com/medline/citation/8732597/Yield_of_surveillance_transbronchial_biopsies_performed_beyond_two_years_after_lung_transplantation_ L2 - http://www.diseaseinfosearch.org/result/7171 DB - PRIME DP - Unbound Medicine ER -