Billingham M E
Department of Pathology, Stanford University Medical School, California 94305.
Am J Cardiovasc Pathol. 1988;1(3):319-34.
Cardiac transplantation offers an excellent chance of long-term survival and functional rehabilitation for the carefully selected patient with end-stage heart disease. The role played by the pathologist in the management of cardiac transplant recipients is a very important one. Although much work is being carried out currently on noninvasive procedures to predict acute rejection, at this time the morphological index of rejection by endomyocardial biopsy is still the only reliable one. Noninvasive techniques are more sensitive because the whole heart can be studied; however, they are still much less specific and cannot distinguish infection from rejection or ischemia. The current management and survival of cardiac allografts depends as much on the pathologist as on his clinical colleagues.
心脏移植为精心挑选的终末期心脏病患者提供了长期存活和功能康复的绝佳机会。病理学家在心脏移植受者的管理中所起的作用非常重要。尽管目前正在开展许多关于预测急性排斥反应的非侵入性检查，但此时，心内膜活检的排斥反应形态学指标仍是唯一可靠的指标。非侵入性技术更为敏感，因为可以对整个心脏进行研究；然而，它们的特异性仍然低得多，无法区分感染、排斥反应或缺血。目前心脏异体移植的管理和存活率同样取决于病理学家及其临床同事。
