Winters G L
Brigham and Women's Hospital, Department of Pathology, Boston, MA 02115, USA.
Curr Opin Cardiol. 1997 Mar;12(2):146-52. doi: 10.1097/00001573-199703000-00009.
The endomyocardial biopsy has long been the preferred technique for monitoring the rejection status of the cardiac allograft. During the past year, published reports have addressed important issues concerning the endomyocardial biopsy, including the reliability of the International Society for Heart and Lung Transplantation grading system; problem areas in posttransplantation biopsy interpretation, including grade 2 rejection and myocyte injury, Quilty lesions, and ischemic injury; the natural history of grade 2 rejection; the necessity of surveillance biopsies late in the posttransplantation course; and the efficacy of numerous noninvasive techniques in diagnosing or predicting rejection. No technique developed to date has been shown to have the sensitivity or specificity needed to replace the endomyocardial biopsy as a diagnostic tool. In addition, studies of endomyocardial biopsy specimens have furthered our understanding of the pathobiology of rejection and other transplant-related conditions.
心内膜心肌活检长期以来一直是监测心脏移植排斥反应状态的首选技术。在过去一年中，已发表的报告讨论了有关心内膜心肌活检的重要问题，包括国际心肺移植学会分级系统的可靠性；移植后活检解读中的问题领域，包括2级排斥反应和心肌细胞损伤、奎尔蒂病变以及缺血性损伤；2级排斥反应的自然病程；移植后期进行监测活检的必要性；以及多种非侵入性技术在诊断或预测排斥反应方面的有效性。迄今为止，尚未有任何已开发的技术被证明具有取代心内膜心肌活检作为诊断工具所需的敏感性或特异性。此外，对心内膜心肌活检标本的研究进一步加深了我们对排斥反应及其他移植相关病症病理生物学的理解。
