Prospective analysis of 1,235 transbronchial lung biopsies in lung transplant recipients
Fiber-optic bronchoscopy with multiple transbronchial lung biopsies (TBB) is the gold standard of evaluation of the pulmonary allograft post–lung transplantation (LT). However, controversy exists regarding the need for surveillance procedures and number of biopsy specimens required for satisfactory...
Gespeichert in:
Veröffentlicht in: | The Journal of heart and lung transplantation 2002-10, Vol.21 (10), p.1062-1067 |
---|---|
Hauptverfasser: | , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 1067 |
---|---|
container_issue | 10 |
container_start_page | 1062 |
container_title | The Journal of heart and lung transplantation |
container_volume | 21 |
creator | Hopkins, Peter M Aboyoun, Christina L Chhajed, Prashant N Malouf, Monique A Plit, Marshall L Rainer, Stephen P Glanville, Allan R |
description | Fiber-optic bronchoscopy with multiple transbronchial lung biopsies (TBB) is the gold standard of evaluation of the pulmonary allograft post–lung transplantation (LT). However, controversy exists regarding the need for surveillance procedures and number of biopsy specimens required for satisfactory yield. The potential morbidity in obtaining multiple TBB specimens remains poorly described. We report the largest series of TBB in LT recipients to date, highlighting the occurrence of acute rejection and infection for surveillance and diagnostic procedures. The safety of TBB is analyzed and a biopsy schedule proposed.
Prospective analysis of 1,235 TBB in 230 LT recipients performed at St Vincent’s Hospital from January 1995 to June 2000.
Eight hundred thirty-six (67.7%) TBB were performed as surveillance and 399 (32.3%) for a clinical indication. No significant acute rejection (AR) or infection was disclosed in 53.3% of procedures. The Lung Rejection Study Group requirement of at least five pieces of evaluable lung parenchyma was achieved in 98.2% of procedures. The average number of evaluable fragments per procedure was 6.4, whereas only 3 TBB (0.24%) contained no lung parenchyma and 44 (3.6%) no bronchial wall. Histologic features of AR, lymphocytic bronchiolitis or infection were found in 18.9% of surveillance and 86.4% of clinical TBBs. The yield of surveillance procedures between 4 and 12 months was just 1.1% for cytomegalovirus and 6.1% for AR. The overall complication rate was 6.35% with no deaths recorded.
Taking 10 to 12 TBB specimens has a high diagnostic yield and rarely fails to provide adequate tissue. The role of surveillance procedures post–lung transplantation remains controversial. |
doi_str_mv | 10.1016/S1053-2498(02)00442-4 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_72610272</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1053249802004424</els_id><sourcerecordid>72610272</sourcerecordid><originalsourceid>FETCH-LOGICAL-c457t-67372585965f945f72c1ee62ef1ccfafe8f739d0edebf23b219cdc2ac065e5293</originalsourceid><addsrcrecordid>eNqFkFtL3UAQgJei1Ft_QiUvSgvG7kyy2eRJRKwKgkJb6Nuy2cy2W3KSuJNzwH_f9ZwjPvo0w_DN7RPiM8hzkFB9-wFSFTmWTf1F4lcpyxLz8oPYB6V0XgDonZS_InvigPmflBILhR_FHmDR1LWW--L3Yxx5IjeHFWV2sP0zB85Gn8FZYrM52oHbOA7ub7B91i-HP1kbxokDcRaGTWENTb0d5iySC1OgYeYjsettz_RpGw_Fr-_XP69u8_uHm7ury_vclUrPeaULjapWTaV8Uyqv0QFRheTBOW891V4XTSepo9Zj0SI0rnNonawUKWyKQ3G6mTvF8WlJPJtFYEd9OofGJRuNFUjUmEC1AV36mCN5M8WwsPHZgDQvSs1aqXnxZSSatVJTpr7j7YJlu6DurWvrMAEnW8Cys71PNlzgN66ERgKoxF1sOEo6VoGiYZdUOepC0jabbgzvnPIfIx6Tng</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>72610272</pqid></control><display><type>article</type><title>Prospective analysis of 1,235 transbronchial lung biopsies in lung transplant recipients</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Hopkins, Peter M ; Aboyoun, Christina L ; Chhajed, Prashant N ; Malouf, Monique A ; Plit, Marshall L ; Rainer, Stephen P ; Glanville, Allan R</creator><creatorcontrib>Hopkins, Peter M ; Aboyoun, Christina L ; Chhajed, Prashant N ; Malouf, Monique A ; Plit, Marshall L ; Rainer, Stephen P ; Glanville, Allan R</creatorcontrib><description>Fiber-optic bronchoscopy with multiple transbronchial lung biopsies (TBB) is the gold standard of evaluation of the pulmonary allograft post–lung transplantation (LT). However, controversy exists regarding the need for surveillance procedures and number of biopsy specimens required for satisfactory yield. The potential morbidity in obtaining multiple TBB specimens remains poorly described. We report the largest series of TBB in LT recipients to date, highlighting the occurrence of acute rejection and infection for surveillance and diagnostic procedures. The safety of TBB is analyzed and a biopsy schedule proposed.
Prospective analysis of 1,235 TBB in 230 LT recipients performed at St Vincent’s Hospital from January 1995 to June 2000.
Eight hundred thirty-six (67.7%) TBB were performed as surveillance and 399 (32.3%) for a clinical indication. No significant acute rejection (AR) or infection was disclosed in 53.3% of procedures. The Lung Rejection Study Group requirement of at least five pieces of evaluable lung parenchyma was achieved in 98.2% of procedures. The average number of evaluable fragments per procedure was 6.4, whereas only 3 TBB (0.24%) contained no lung parenchyma and 44 (3.6%) no bronchial wall. Histologic features of AR, lymphocytic bronchiolitis or infection were found in 18.9% of surveillance and 86.4% of clinical TBBs. The yield of surveillance procedures between 4 and 12 months was just 1.1% for cytomegalovirus and 6.1% for AR. The overall complication rate was 6.35% with no deaths recorded.
Taking 10 to 12 TBB specimens has a high diagnostic yield and rarely fails to provide adequate tissue. The role of surveillance procedures post–lung transplantation remains controversial.</description><identifier>ISSN: 1053-2498</identifier><identifier>EISSN: 1557-3117</identifier><identifier>DOI: 10.1016/S1053-2498(02)00442-4</identifier><identifier>PMID: 12398870</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Biopsy - methods ; Bronchi - pathology ; Bronchoscopy ; Child ; Female ; Graft Rejection - pathology ; Humans ; Lung Transplantation ; Male ; Medical sciences ; Middle Aged ; Postoperative Period ; Prospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the respiratory system ; Transplantation, Homologous</subject><ispartof>The Journal of heart and lung transplantation, 2002-10, Vol.21 (10), p.1062-1067</ispartof><rights>2002 International Society for Heart and Lung Transplantation</rights><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c457t-67372585965f945f72c1ee62ef1ccfafe8f739d0edebf23b219cdc2ac065e5293</citedby><cites>FETCH-LOGICAL-c457t-67372585965f945f72c1ee62ef1ccfafe8f739d0edebf23b219cdc2ac065e5293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1053249802004424$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14190115$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12398870$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hopkins, Peter M</creatorcontrib><creatorcontrib>Aboyoun, Christina L</creatorcontrib><creatorcontrib>Chhajed, Prashant N</creatorcontrib><creatorcontrib>Malouf, Monique A</creatorcontrib><creatorcontrib>Plit, Marshall L</creatorcontrib><creatorcontrib>Rainer, Stephen P</creatorcontrib><creatorcontrib>Glanville, Allan R</creatorcontrib><title>Prospective analysis of 1,235 transbronchial lung biopsies in lung transplant recipients</title><title>The Journal of heart and lung transplantation</title><addtitle>J Heart Lung Transplant</addtitle><description>Fiber-optic bronchoscopy with multiple transbronchial lung biopsies (TBB) is the gold standard of evaluation of the pulmonary allograft post–lung transplantation (LT). However, controversy exists regarding the need for surveillance procedures and number of biopsy specimens required for satisfactory yield. The potential morbidity in obtaining multiple TBB specimens remains poorly described. We report the largest series of TBB in LT recipients to date, highlighting the occurrence of acute rejection and infection for surveillance and diagnostic procedures. The safety of TBB is analyzed and a biopsy schedule proposed.
Prospective analysis of 1,235 TBB in 230 LT recipients performed at St Vincent’s Hospital from January 1995 to June 2000.
Eight hundred thirty-six (67.7%) TBB were performed as surveillance and 399 (32.3%) for a clinical indication. No significant acute rejection (AR) or infection was disclosed in 53.3% of procedures. The Lung Rejection Study Group requirement of at least five pieces of evaluable lung parenchyma was achieved in 98.2% of procedures. The average number of evaluable fragments per procedure was 6.4, whereas only 3 TBB (0.24%) contained no lung parenchyma and 44 (3.6%) no bronchial wall. Histologic features of AR, lymphocytic bronchiolitis or infection were found in 18.9% of surveillance and 86.4% of clinical TBBs. The yield of surveillance procedures between 4 and 12 months was just 1.1% for cytomegalovirus and 6.1% for AR. The overall complication rate was 6.35% with no deaths recorded.
Taking 10 to 12 TBB specimens has a high diagnostic yield and rarely fails to provide adequate tissue. The role of surveillance procedures post–lung transplantation remains controversial.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Biopsy - methods</subject><subject>Bronchi - pathology</subject><subject>Bronchoscopy</subject><subject>Child</subject><subject>Female</subject><subject>Graft Rejection - pathology</subject><subject>Humans</subject><subject>Lung Transplantation</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Postoperative Period</subject><subject>Prospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the respiratory system</subject><subject>Transplantation, Homologous</subject><issn>1053-2498</issn><issn>1557-3117</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkFtL3UAQgJei1Ft_QiUvSgvG7kyy2eRJRKwKgkJb6Nuy2cy2W3KSuJNzwH_f9ZwjPvo0w_DN7RPiM8hzkFB9-wFSFTmWTf1F4lcpyxLz8oPYB6V0XgDonZS_InvigPmflBILhR_FHmDR1LWW--L3Yxx5IjeHFWV2sP0zB85Gn8FZYrM52oHbOA7ub7B91i-HP1kbxokDcRaGTWENTb0d5iySC1OgYeYjsettz_RpGw_Fr-_XP69u8_uHm7ury_vclUrPeaULjapWTaV8Uyqv0QFRheTBOW891V4XTSepo9Zj0SI0rnNonawUKWyKQ3G6mTvF8WlJPJtFYEd9OofGJRuNFUjUmEC1AV36mCN5M8WwsPHZgDQvSs1aqXnxZSSatVJTpr7j7YJlu6DurWvrMAEnW8Cys71PNlzgN66ERgKoxF1sOEo6VoGiYZdUOepC0jabbgzvnPIfIx6Tng</recordid><startdate>20021001</startdate><enddate>20021001</enddate><creator>Hopkins, Peter M</creator><creator>Aboyoun, Christina L</creator><creator>Chhajed, Prashant N</creator><creator>Malouf, Monique A</creator><creator>Plit, Marshall L</creator><creator>Rainer, Stephen P</creator><creator>Glanville, Allan R</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20021001</creationdate><title>Prospective analysis of 1,235 transbronchial lung biopsies in lung transplant recipients</title><author>Hopkins, Peter M ; Aboyoun, Christina L ; Chhajed, Prashant N ; Malouf, Monique A ; Plit, Marshall L ; Rainer, Stephen P ; Glanville, Allan R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c457t-67372585965f945f72c1ee62ef1ccfafe8f739d0edebf23b219cdc2ac065e5293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Biopsy - methods</topic><topic>Bronchi - pathology</topic><topic>Bronchoscopy</topic><topic>Child</topic><topic>Female</topic><topic>Graft Rejection - pathology</topic><topic>Humans</topic><topic>Lung Transplantation</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Postoperative Period</topic><topic>Prospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the respiratory system</topic><topic>Transplantation, Homologous</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hopkins, Peter M</creatorcontrib><creatorcontrib>Aboyoun, Christina L</creatorcontrib><creatorcontrib>Chhajed, Prashant N</creatorcontrib><creatorcontrib>Malouf, Monique A</creatorcontrib><creatorcontrib>Plit, Marshall L</creatorcontrib><creatorcontrib>Rainer, Stephen P</creatorcontrib><creatorcontrib>Glanville, Allan R</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of heart and lung transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hopkins, Peter M</au><au>Aboyoun, Christina L</au><au>Chhajed, Prashant N</au><au>Malouf, Monique A</au><au>Plit, Marshall L</au><au>Rainer, Stephen P</au><au>Glanville, Allan R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective analysis of 1,235 transbronchial lung biopsies in lung transplant recipients</atitle><jtitle>The Journal of heart and lung transplantation</jtitle><addtitle>J Heart Lung Transplant</addtitle><date>2002-10-01</date><risdate>2002</risdate><volume>21</volume><issue>10</issue><spage>1062</spage><epage>1067</epage><pages>1062-1067</pages><issn>1053-2498</issn><eissn>1557-3117</eissn><abstract>Fiber-optic bronchoscopy with multiple transbronchial lung biopsies (TBB) is the gold standard of evaluation of the pulmonary allograft post–lung transplantation (LT). However, controversy exists regarding the need for surveillance procedures and number of biopsy specimens required for satisfactory yield. The potential morbidity in obtaining multiple TBB specimens remains poorly described. We report the largest series of TBB in LT recipients to date, highlighting the occurrence of acute rejection and infection for surveillance and diagnostic procedures. The safety of TBB is analyzed and a biopsy schedule proposed.
Prospective analysis of 1,235 TBB in 230 LT recipients performed at St Vincent’s Hospital from January 1995 to June 2000.
Eight hundred thirty-six (67.7%) TBB were performed as surveillance and 399 (32.3%) for a clinical indication. No significant acute rejection (AR) or infection was disclosed in 53.3% of procedures. The Lung Rejection Study Group requirement of at least five pieces of evaluable lung parenchyma was achieved in 98.2% of procedures. The average number of evaluable fragments per procedure was 6.4, whereas only 3 TBB (0.24%) contained no lung parenchyma and 44 (3.6%) no bronchial wall. Histologic features of AR, lymphocytic bronchiolitis or infection were found in 18.9% of surveillance and 86.4% of clinical TBBs. The yield of surveillance procedures between 4 and 12 months was just 1.1% for cytomegalovirus and 6.1% for AR. The overall complication rate was 6.35% with no deaths recorded.
Taking 10 to 12 TBB specimens has a high diagnostic yield and rarely fails to provide adequate tissue. The role of surveillance procedures post–lung transplantation remains controversial.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12398870</pmid><doi>10.1016/S1053-2498(02)00442-4</doi><tpages>6</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1053-2498 |
ispartof | The Journal of heart and lung transplantation, 2002-10, Vol.21 (10), p.1062-1067 |
issn | 1053-2498 1557-3117 |
language | eng |
recordid | cdi_proquest_miscellaneous_72610272 |
source | MEDLINE; Elsevier ScienceDirect Journals |
subjects | Adolescent Adult Biological and medical sciences Biopsy - methods Bronchi - pathology Bronchoscopy Child Female Graft Rejection - pathology Humans Lung Transplantation Male Medical sciences Middle Aged Postoperative Period Prospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the respiratory system Transplantation, Homologous |
title | Prospective analysis of 1,235 transbronchial lung biopsies in lung transplant recipients |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T07%3A15%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prospective%20analysis%20of%201,235%20transbronchial%20lung%20biopsies%20in%20lung%20transplant%20recipients&rft.jtitle=The%20Journal%20of%20heart%20and%20lung%20transplantation&rft.au=Hopkins,%20Peter%20M&rft.date=2002-10-01&rft.volume=21&rft.issue=10&rft.spage=1062&rft.epage=1067&rft.pages=1062-1067&rft.issn=1053-2498&rft.eissn=1557-3117&rft_id=info:doi/10.1016/S1053-2498(02)00442-4&rft_dat=%3Cproquest_cross%3E72610272%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=72610272&rft_id=info:pmid/12398870&rft_els_id=S1053249802004424&rfr_iscdi=true |