Non-invasive early detection of acute and chronic rejection after heart and/or lung transplantation

通过电生理和放射学方法早期检测急性和慢性排斥反应的可能性进行了评估，在胸内心脏和/或肺移植模型的专门治疗的狗无感染。作为移植心脏的电生理检查，在一周内多次测量传导系统的有效不应期，每次检查后立即进行心肌活检。作为放射学评估，每周评估一次吸入肺的X线透明度，每次评估后立即进行肺活检。根据国际心肺移植学会的标准化排斥反应分级系统评估心脏和肺活检标本的组织学表现。结果表明，移植心脏传导系统的有效不应期在轻度至中度排斥反应中随排斥反应组织病理学分级的增加而延长。当移植肺发生中、重度排斥反应时，吸入肺的X线透明度降低。本研究结果提示，传导系统有效不应期和吸入肺X线透明度可作为心肺移植术后急、慢性排斥反应的无创性早期检测指标。

Possibility for early detection of acute and chronic rejection by means of electrophysiologic and radiographic methods was assessed in intrathoracic heart and/or lung transplant models of specially-treated dogs without infection. As the electrophysiologic examination of the transplanted heart, effective refractory period of conduction system was measured a few times in a week, and myocardial biopsy was performed immediately after each examination. As the radiographic evaluation, X-ray transparency of inhaled lung was assessed once a week, and lung biopsy was performed immediately after each evaluation. Histopathologic findings of the heart and lung biopsy specimens were assessed according to the standardized grading system of rejection of the international society for heart and lung transplantation. In results of this investigation, effective refractory period of conduction system in the transplanted heart was more elongated during mild to moderate rejection as histopathologic grade of rejection increased. X-ray transparency of inhaled lung decreased when moderate to severe rejection occurred in the transplanted lung. These results of this study suggested that effective refractory period of conduction system and X-ray transparency of inhaled lung might be useful measures for non-invasive early detection of acute and chronic rejection after heart and/or lung transplantation.