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Algorithms for Management of Heart Transplant Rejection Based on Surveillance of Myocardial Damage by Antimyosin Antibody Imaging

  • Manel Ballester
  • Ignasi Carrió
  • Jagat Narula

Abstract

Endomyocardial biopsy remains the only reliable diagnostic tool to detect acute allograft rejection (see Chapters 9,13)1–2. Biopsies are performed serially after transplantation, especially during the initial months. Immunosuppressive treatment is augmented when myocyte damage is detected by biopsy. Biopsy-based patient management is widely used and has been associated with very good long-term survival.3 However, there are significant limitations of endomyocardial biopsy. These include high procedural cost, a small but definite morbidity, and dwindling yield in obtaining adequate myocardial samples after the first year of transplantation. In addition, sampling error of the biopsy to detect acute rejection remains a major problem since myocardial expression of acute rejection is not a diffuse but rather a patchy. Rarely, patients who die of acute rejection demonstrate foci of myocardial damage and inflammation which can be seen surrounded by large areas of apparently intact myocardium.4,5

Keywords

Acute Rejection Myocardial Damage Endomyocardial Biopsy Cardiac Allograft Rejection Myocyte Damage 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Manel Ballester
    • 1
  • Ignasi Carrió
    • 2
  • Jagat Narula
    • 3
  1. 1.Department of CardiologyLleida UniversityLleidaSpain
  2. 2.Department of Nuclear Medicine Hospital de Sant PauBarcelonaSpain
  3. 3.Heart Failure/Transplantation CenterHahnemann University HospitalPhiladelphiaUSA

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