Monitoring of Acute Rejection after Orthotopic Heart Tranplantation

Objectives To study the monitoring of rejection after orthotopic heart thansplantation. Methods From 1998 to 2005, 10 othotopic heart thansplans were performed, and acute rejection was monitored by endomyocardial biopsy as well as by clinical features, ECG, ultrasonocardiography and blood serum determination of Tropin I, and by the combination of these methods, we analysed the monitoring of acute rejection after the heart transplantation. Results With the combination of clinical features, ECG, ultrasonocardiography and blood serum test, 5 occurences of acute rejection were judged in the postoperative course, which were comfirmed by endomyocardial biopsy to be 2 acute rejections inⅠb degree, 3 acute rejections inⅢa degree. Endomyocardial biopsy were routinely performed 21 times postoperatively in which there were 1 acute rejection inⅠa degree and 5 acute rejections inⅠb degree. Conclusions Acute rejection is an important factor influencing the postoperative course of heart transplantation, so it is imperative to have an in-time, effective and planned monitoring procedure for acute rejection. Endomyocardial biopsy is a sensitive and reliable method in diagnosis of acute rejection, but it is invasive and probable for some complications. The noninvasive method such as clinical features, ECG, ultrasonocardiography and blood serum test can be used as additive means in the diagnosis of acute rejection. Endomyocardial biopsy should be combined with some noninvasive methods in monitoring acute rejection after the heart transplantation.

Monitoring of Acute Rejection after Orthotopic Heart Tranplantation