Introduction: Endomyocardial biopsy is the standard means of establishing cardiac allograft rejection diagnosis. The efficacy of this procedure in xenotransplantation has not been determined. In this study we compare the histology of right ventricular endomyocardial biopsy specimens with the corresponding full cross sections of explanted right ventricle (RV). We also compare RV with the related left ventricle (LV) cross sections.
Methods: Heterotopic CD46 pig-to-baboon cardiac xenotransplants (n = 64) were studied. RV endomyocardial biopsy specimens were taken at cardiac explant by using a standard bioptome (n = 24) or by sharp dissection (n = 40). Hematoxylin and eosin stained sections of RV and LV cross-section and RV endomyocardial biopsy specimens were compared in a blinded fashion. Characteristics of delayed xenograft rejection and a global assessment of ischemia were scored from 0 to 4 according to the percentage of myocardium involved (0, 0%; 1, 1%-25%; 2, 26%-50%; 3, 51%-75%; and 4, 76%-100%).
Results: Median graft survival was 30 days (range, 3-137 days). Linear regression analysis of histology scores demonstrated that specimens from both bioptome and sharp dissection equally represented the histology of the RV cross section. Global ischemic injury was strongly correlated between RV and RV endomyocardial biopsy (R(2) = 0.84) and between RV and LV cross sections (R(2) = 0.84). Individual characteristics of delayed xenograft rejection showed no significant variation between RV and RV endomyocardial biopsy or between RV and LV (p < 0.05).
Conclusions: These results indicate that delayed xenograft rejection is a widespread process involving both right and left ventricles similarly. This study shows that histologic assessment of RV endomyocardial biopsy specimens is an effective method for the monitoring of delayed xenograft rejection after cardiac xenotransplantation.
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http://dx.doi.org/10.1016/j.healun.2007.07.028 | DOI Listing |
JACC Case Rep
January 2025
Department of Clinical Cardiology, Cleveland Clinic, Cleveland, Ohio, USA.
This case series highlights the role of endomyocardial biopsy (EMB) in diagnosing cardiac tumors instead of tumor resection. EMB provided critical diagnostic clarity and influenced therapeutic decisions, demonstrating its utility in complex cardiovascular cases while preventing unnecessary surgery. Furthermore, EMB provides vital information that can be used for a multidisciplinary approach to cardiac tumors.
View Article and Find Full Text PDFJACC Case Rep
December 2024
Department of Cardiology, Centro Hospitalar Universitário Lisboa Norte,Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina da Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.
An 80-year-old woman with a history of B-cell non-Hodgkin lymphoma presented to the emergency department with exertional dyspnea and lower limb edema. A transthoracic echocardiogram revealed a large extracardiac mass invading the right atrium. A diagnostic transcatheter endomyocardial biopsy guided by intracardiac echocardiography was performed.
View Article and Find Full Text PDFKorean Circ J
December 2024
Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Background And Objectives: Data are limited on the clinical manifestations and outcomes of acute myocarditis from a large-scale registry. We investigated acute myocarditis's clinical characteristics and prognosis from a large-scale, multi-center registry in the Republic of Korea.
Methods: We collected data from seven hospitals between 2001 and 2021.
Endomyocardial biopsies (EMB) are invasive procedures performed in heart transplant (HTx) patients for surveillance of acute rejection. However, patient preferences for replacing EMBs with noninvasive assays in the context of potential institutional policy changes are unknown. A mixed-methods design was used with 28 semi-structured patient interviews and 123 self-administered online survey questionnaires in English and Spanish between January to June 2023.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Department of Cardiology, York Hospital, WellSpan Health, 30 Monument Rd, York, PA 17403, USA.
Background: ROS1 tyrosine kinase inhibitors are one of the primary immunotherapies for fusion-positive cancers. Tyrosine kinase inhibitors have markedly improved outcomes for advanced cancers previously with poor prognosis. Entrectinib is an example of an ROS1 inhibitor that can be used for lung adenocarcinoma.
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