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• W2000271340 abstract "The need of routine endomyocardial biopsy (EMB) to monitor acute cellular rejection (ACR) late (> 1 year) after heart transplantation (HT), is not clear. We therefore studied the incidence of late ACR, potentially associated risk factors, and the relationship between early and late ACR. 3829 EMBs from 215 HT-patients at our centre 1988-2010, were graded according to the 1990-ISHLT-WF and retrospectively reviewed. End of follow-up was June 30, 2012. Late EMBs (> 1 year) (n=839) were specifically analysed and compared to early EMBs (≤ 1 year) (n=2990). The distribution of ACR-grades among the late EMBs were; grade 0 (60.1%), 1A (15.6%), 1B (13.0%), 2 (4.4%), 3A (6.3%), 3B (0.5%) and 4 (0.1%). ACR ≥ grade 2 was more common (p<0.05) among late EMBs performed on clinical indication (17.5%, n=440), than among late routine EMBs (4.5%, n=399). The total number of ACRs ≥ grade 2, and the incidence of ACRs ≥ grade 2 per patient per year, were 62 and 0.17 year 2-3, 11 and 0.03 year 4-5, 9 and 0.03 year 6-7, 6 and 0.02 year 8-9, as well as 7 and 0.02 ≥ 10 years, respectively, compared with 222 and 1.06, respectively, during the first year after HT (Figure 1). HTs with late ACRs ≥ grade 2, as compared to HTs without late ACRs ≥ grade 2, generally involved younger (p<0.05) recipients (47 vs. 51) and donors (39 vs. 45), as well as a higher (p<0.05) proportion of sex-mismatched patients (44% vs. 21%) and a constellation of CMV positive donor / CMV negative recipient (34% vs. 16%). Patients with early ACRs ≥ grade 2, as compared to patients without early ACRs ≥ grade 2, also had more (p<0.05) late ACRs ≥ grade 2 and a shorter (p<0.05) time to first late ACRs ≥ grade 2. The incidence of severe ACR late after HT is low. Late ACRs, however, seem to be more common after HT with young recipients, young donors, sex-mismatched patients and a constellation of CMV positive donor / CMV negative recipient. Patients with early ACR, furthermore, appear to be at an increased risk of late ACR." @default.
• W2000271340 created "2016-06-24" @default.
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• W2000271340 date "2015-04-01" @default.
• W2000271340 modified "2023-09-27" @default.
• W2000271340 title "Acute Cellular Rejection Later Than One Year After Heart Transplantation: A Single Centre Retrospective Study at Skåne University Hospital in Lund 1988-2010" @default.
• W2000271340 doi "https://doi.org/10.1016/j.healun.2015.01.844" @default.
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