[Heart transplantation: life-long biopsies for prevention of rejection?].
The transplantation of a heart restores the quality of life and productivity to patients who have experienced severe loss of contractility of heart muscle during an infection or as a result of long-lasting chronic heart disease. Monitoring for allograft rejection requires expensive procedures whereby, with catheterisation of the right heart, endomyocardial biopsies are retrieved. Evaluation by the pathologist uses a standardised diagnostic scheme which is in use worldwide. We have tested the interobserver agreement in a very heterogeneous group of examining pathologists and found moderate agreement with a kappa value of 0.52. The development of other methods to improve and even to replace invasive procedures for monitoring acceptance/rejection of a cardiac allograft requires interdisciplinary cooperation.
Stallmach
T
T
Departement Pathologie, Universitätsspital Zürich. thomas.stallmach@pty.usz.ch
Gaspert
A
A
Ersch
J
J
Oechslin
E
E
D001706:Biopsy; D004699:Endocardium / Q000473:pathology*; D006084:Graft Rejection / Q000473:pathology / Q000517:prevention & control*; D016027:Heart Transplantation / Q000473:pathology*; D006801:Humans; D009206:Myocardium / Q000473:pathology*; D015588:Observer Variation; D010348:Patient Care Team