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P14.01 Cryobiopsy in the diagnosis of lung allograft rejection : Brazilian case series.

Carlos E Belon, Brazil

Heart institute - Incor

Abstract

Cryobiopsy in the diagnosis of lung allograft rejection: Brazilian case series

Carlos E F Belon1, Elissa A Okuno1, Silvia V Campos1, Ascedio J Rodrigues1, Evelisse Lima1, Paulo R Scordamaglio1, Priscila C L B Camargo1, Ricardo H O B Teixeira1, Rafael M Carraro1, Andre N Costa1, Juliana P Pires1, Flávio P Reis1, Lucas M Fernandes1, Luis G Abdalla1, Paulo M P Fernandes1, Mauro R Filho1, Samuel L Santos1.

1Department of Lung Transplantation, Instituto do Coração - InCor, Heart Institute - University of São Paulo, São Paulo, Brazil

Introduction: Bronchoscopy with transbronchial biopsy is the main tool for diagnosing lung allograft  rejection and is also used in lung transplantation recipients follow-up. Recent trials have shown a higher sensitivity value in cryobiopsy than transbronchial biopsy for allograft rejection.

Method: Four cases of lung transplantation in a single center in Brazil were analyzed for allograft rejection with transbronchial cryobiopsy. The materials were examined by the same pathologist in all cases and  the results were based on the 2007 International Society for Heart and Lung Transplantation (ISHLT) grading for allograft rejection.

Results: Four pulmonary transplanted patients were submitted to transbronchial biopsy, which either resulted inconclusive (Ax according  with ISHLT grading for allograft rejection) or inconsistent with clinical manifestations and pulmonary function. As an outcome, those patients underwent cryobiopsy to investigate allograft dysfunction. All of them had their rejection grading modified after the procedure and  therefore their treatment which consisted in  pulse therapy with methylprednisolone. The characteristics  of the patients are described in Table1.

Conclusion: Cryobiopsy is an accurate procedure for diagnosing cellular allograft rejection post lung transplant and can change treatment for patients.

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