Key result
For-cause endomyocardial biopsies detected significantly more treated acute rejection than surveillance biopsies (14.2% vs 1.2%, OR 9.17), whereas surveillance biopsies resulted in a higher incidence of complications than detected rejection.
Why the study?
Endomyocardial biopsy is the reference standard for detecting acute rejection in adult HTx patients, but the incidence of treated acute rejection compared with biopsy complications had not been evaluated in the contemporary era.
Does surveillance endomyocardial biopsy yield more treated acute rejection episodes than procedure-related complications compared to for-cause biopsy in heart transplant patients?
Population
326 consecutive HTx patients undergoing 2769 EMBs
Comparison
Surveillance vs for-cause EMBs
Design
Retrospective cohort study
Authors
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Surveillance EMBs may carry higher complication than rejection risk; leaves open whether protocols need reevaluation pending randomized data.
Observational (n=326)
No
Does surveillance endomyocardial biopsy yield more treated acute rejection episodes than procedure-related complications compared to for-cause biopsy in heart transplant patients?
Odds Ratio: 9.17 (95% CI 4.56–18.46)
Absolute Event Rate: 14.2% vs 1.2%
p-value: p=<0.001
In the contemporary era, routine surveillance endomyocardial biopsies in heart transplant patients yield a higher incidence of procedure-related complications than treated acute rejection episodes, suggesting that current surveillance protocols should be reevaluated.
Cusi et al. (2023) conducted an observational in Heart transplantation (n=326). For-cause endomyocardial biopsy vs. Surveillance endomyocardial biopsy was evaluated on Treated acute rejection (OR 9.17, 95% CI 4.56-18.46, p=<0.001). For-cause endomyocardial biopsies detected significantly more treated acute rejection than surveillance biopsies (14.2% vs 1.2%, OR 9.17), whereas surveillance biopsies resulted in a higher incidence of complications than detected rejection.
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