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Advances in methods for surveillance of rejection

Published online by Cambridge University Press:  21 September 2005

Robert J. Boucek Jr ,
Mark M. Boucek  and
Alfred Asante-Korang
Robert J. Boucek Jr
Affiliation:
Division of Pediatric Cardiology, Congenital Heart Institute of Florida and University of South Florida/All Children's Hospital, St Petersburg, Florida, USA
Mark M. Boucek
Affiliation:
Denver Children's Hospital, Denver, Colorado, USA
Alfred Asante-Korang
Affiliation:
Division of Pediatric Cardiology, Congenital Heart Institute of Florida and University of South Florida/All Children's Hospital, St Petersburg, Florida, USA
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Extract

Transplantation is an effective treatment modality for infants1 and children2 with end-stage cardiac diseases. Rejection remains a major complication (Figure 1), even in newborn infants.3 Acute rejection can best be operationally defined by clinical findings, histopathology, and/or abnormalities of ventricular function of new origin that require, and respond to, intensified immunosuppression. Mechanistically, the ability to detect acute rejection is critically dependent on the detection of significant new myocytic injury, damage, and/or death. Surveillance for rejection is critically important in determining both long and short-term outcomes following cardiac transplantation. The ideal strategy for surveillance should have a high negative predictive value, correctly identifying the absence of myocytic injury, with high specificity, such that it does not falsely predict such injury.4

Information

Type
Heart Transplantation
Information
Cardiology in the Young , Volume 14 , Issue S1 , February 2004 , pp. 93 - 96
Copyright
© 2004 Cambridge University Press

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