Futility of yearly heart biopsies in patients undergoing heart transplantation.
Three hundred thirty-eight endomyocardial biopsies, performed as part of the routine annual evaluation at 1 or more years after transplantation in 211 patients, were reviewed. In only two instances (0.6%) were the histologic findings suggestive, but not pathognomonic, of acute rejection. Both patients were treated for rejection and are doing well at 4 and 6 years postoperatively. On the basis of the results of this study, we believe that routine yearly heart biopsies in asymptomatic patients are not necessary for long-term care of patients after heart transplantation, and we believe they should be performed only if there is clinical suspicion of rejection or as part of a research protocol.
Sethi
G K
GK
Division of Cardiovascular, University of Arizona, Tucson 85724.
Rosado
L J
LJ
McCarthy
M
M
Butman
S S
SS
Copeland
J G
JG
D000206:Actuarial Analysis; D001706:Biopsy / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006084:Graft Rejection; D016027:Heart Transplantation / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D013997:Time Factors