https://scholars.lib.ntu.edu.tw/handle/123456789/560037
標題: | Endomyocardial biopsy in heart transplantation: Schedule or event? | 作者: | NAI-HSIN CHI NAI-KUAN CHOU Tsao C.-I. SHU-CHIEN HUANG I-HUI WU HSI-YU YU YIH-SHARNG CHEN SHOEI-SHEN WANG |
公開日期: | 五月-2012 | 卷: | 44 | 期: | 4 | 起(迄)頁: | 894 | 來源出版物: | Transplantation Proceedings | 摘要: | Background: Endomyocardial biopsy is the gold standard to identify rejection after heart transplantation. Due to its invasiveness, discomfort, and difficult vascular access, some patients are not willing to accept routine scheduled biopsies years after heart transplantation. The purpose of this study was to identify whether there was a difference in outcomes among the scheduled versus event biopsy groups. Methods: We studied 411 patients who underwent heart transplantation from 1987 to 2011, reviewing biopsy results and pathology reports. There were 363 patients who followed the scheduled biopsy protocol, and 48 patients who were assigned to the event biopsy group. We extracted data on biopsy results, rejection episodes, rejection types, and survival time. Results: The 2481 reviewed biopsies over 24 years, showed most rejection episodes (86.4%) to occur within 2 years after heart transplantation. The rejection incidence was low (2.1%) at 3 years after transplantation. The major reason for an event biopsy was poor vascular access, such as tiny central vein or congenital disease without a suitable central vein. Event biopsy group patients were younger than schedule biopsy patients (19.7 years old vs 47.6 years old; P <.05). The 10-year survival rates were 64% among the event versus 53% among the scheduled biopsy group (P =.029). The 10-year rates of freedom from rejection were similar. Conclusions: The rejection rate was low after 3 years; episodes occurred within 2 years. Although the long-term survival in the event group was better, they had a younger man age. The rejection and freedom from rejection rates were similar. As the rejection rate was low at 3 years after transplantation, we suggest that the event principle could be applied for biopsy at 3 years after heart transplantation. ? 2012 Elsevier Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84860731485&doi=10.1016%2fj.transproceed.2012.02.010&partnerID=40&md5=2e2eb9e1268b87a93f519bc056a0b86b https://scholars.lib.ntu.edu.tw/handle/123456789/560037 |
ISSN: | 0041-1345 | DOI: | 10.1016/j.transproceed.2012.02.010 | SDG/關鍵字: | age; cardiac graft rejection; central vein; central venous pressure; conference paper; female; gold standard; heart muscle biopsy; heart output; heart transplantation; human; human tissue; incidence; lung artery pressure; lung vascular resistance; major clinical study; male; outcome assessment; priority journal; survival time; vascular access; Adolescent; Adult; Biopsy; Child; Child, Preschool; Disease-Free Survival; Female; Graft Rejection; Graft Survival; Heart Transplantation; Humans; Immunosuppressive Agents; Kaplan-Meier Estimate; Male; Middle Aged; Myocardium; Predictive Value of Tests; Risk Assessment; Risk Factors; Taiwan; Time Factors; Treatment Outcome; Young Adult |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。