Back to Search
Start Over
Immunohistochemical Quantification of Inflammatory Cells in Endomyocardial Biopsy Fragments After Heart Transplantation: A New Potential Method to Improve the Diagnosis of Rejection After Heart Transplantation
- Source :
- Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual), Universidade de São Paulo (USP), instacron:USP
- Publication Year :
- 2014
- Publisher :
- Elsevier BV, 2014.
-
Abstract
- Inconsistencies in cardiac rejection grading systems corroborate the concept that the evaluation of inflammatory intensity and myocyte damage seems to be subjective. We studied in 36 patients the potential role of the immunohistochemical (IHC) counting of inflammatory cells in endomyocardial biopsy (EMB) as an objective tool, testing the hypothesis of correlation between the International Society for Heart and Lung Transplantation 2004 rejection and IHC counting of inflammatory cells. We observed a progressive increment in CD68+ cells/mm 2 ( P = .000) and CD3+ cells/mm 2 ( P = .000) with higher rejection grade. A strong correlation between the grade of cellular rejection and both CD68+ cells/mm 2 and CD3+ cells/mm 2 was obtained ( P = .000). One patient with CD3+ and CD68+ cells/mm 2 above the upper limit of the 95% confidence interval for cells/mm 2 found in rejection grade 1R evolved to rejection grade 2R without treatment. In patients with 2R that did not respond to treatment the values of CD68+ or CD3+ cells were higher than the overall median values for rejection grade 2R. For diagnosis of rejection needing treatment, the CD68+ and CD3+ cells/mm 2 areas under the receiver operating characteristic curves were 0.956 and 0.934, respectively. IHC counting of mononuclear inflammatory infiltrate in EMB seems to have additive potential role in evaluation of EMB for the diagnosis and prognosis of rejection episodes.
- Subjects :
- Adult
Graft Rejection
Male
Pathology
medicine.medical_specialty
Biopsy
medicine.medical_treatment
CD3
FÁRMACOS IMUNOSSUPRESSORES
Antigens, CD
medicine
Animals
Humans
Lung transplantation
Myocyte
Grading (tumors)
Heart transplantation
Transplantation
biology
Receiver operating characteristic
business.industry
CD68
Myocardium
Immunohistochemistry
Cats
Leukocytes, Mononuclear
biology.protein
Heart Transplantation
Female
Surgery
business
Subjects
Details
- ISSN :
- 00411345
- Volume :
- 46
- Database :
- OpenAIRE
- Journal :
- Transplantation Proceedings
- Accession number :
- edsair.doi.dedup.....18e41bafe3b247fef0e5638a4f1c0096