Evaluation of the International Society for Heart Transplantation (ISHT) grading of pulmonary rejection in 100 consecutive biopsies

  • J. Hunt
  • S. Stewart
  • N. Cary
  • T. Wreghitt
  • T. Higenbottam
  • J. Wallwork
Conference paper


Heart-lung and lung transplantation are accepted treatments for patients with end-stage pulmonary vascular disease or parenchymal lung disease [4, 5, 10]. Survival rates for heart-lung and lung transplantation are lower than those for heart transplantation alone. The 5-year actuarial survival forheart-lung transplantation has been 41% largely due to rejection and infection remaining as the limiting factors for long-term survival [3].

Key words

Pulmonary rejection ISHT grading TBBs histology 


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  1. 1.
    Higenbottam T, Stewart S, Penketh A, Wallwork J (1988) Trans-bronchial lung biopsy for the diagnosis of rejection in heart-lung transplant patients. Transplantation 46:532–539PubMedCrossRefGoogle Scholar
  2. 2.
    Higenbottam T, Stewart S, Wallwork J (1988) Transbronchial lung biopsy to diagnose lung rejection and infection of heart-lung transplants. Transplant Proc 20:767–769Google Scholar
  3. 3.
    Kriett JM, Kaye MP (1991) The Registry of the International Society for Heart and Lung Transplantation: Eighth Official Report -1991. J Heart Lung Transplant 10:491–498PubMedGoogle Scholar
  4. 4.
    Penketh ARL, Higenbottam TW, Hakim M, Wallwork J (1987) Heart and lung transplantation in patients with end-stage lung disease. Br Med J 295:311–314CrossRefGoogle Scholar
  5. 5.
    Reitz BA, Wallwork J, Hunt SA, Pennock JL, Billingham ME, Oyer PE, Stinson EB, Shumway NE (1982) Heart lung transplantation? Successful therapy for patients with pulmonary vascular disease. N Engl J Med 306:557–564PubMedCrossRefGoogle Scholar
  6. 6.
    Sissons JGP, Borysiewicz LK (1989) Human cytomegalovirus infection. Thorax 44:241–246PubMedCrossRefGoogle Scholar
  7. 7.
    Steinhoff G, Behrend M, Wagner TOF, Hoper MH, Haverich A (1991) Early diagnosis and effective treatment of pulmonary CMV infection after lung transplantation. J Heart Lung Transplant 10:9–14PubMedGoogle Scholar
  8. 8.
    Stewart S, Higenbottam TW, Hutter JW, Penketh ARL, Zebro TJ, Wallwork J (1988) Histopathology of transbronchial biopsies in heart-lung transplantation. Transplant Proc 20:764–766Google Scholar
  9. 9.
    Tazelaar HD (1991) Perivascular inflammation in pulmonary infections: implications for the diagnosis of lung rejection. J Heart Lung Transplant 10:437–441PubMedGoogle Scholar
  10. 10.
    Theodore J, Levington N (1990) Lung transplantation comes of age. N Engl J Med 332:772–774CrossRefGoogle Scholar
  11. 11.
    Weiss LM, Movahed LA, Berry GJ, Billingham ME (1990) In situ hybridization studies for viral nucleic acids in heart and lung allograft biopsies. Am J Clin Pathol 93:675–679PubMedGoogle Scholar
  12. 12.
    Yousem SA, Berry GJ, Brunt EM, Chamberlain D, Hruban RH, Sibley RK, Stewart S, Tazelaar H (1990) A working formulation for the standardisation of nomenclature in the diagnosis of the heart and lung rejection: Lung Rejection Study Group. J Heart Transplant 9:593–601Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • J. Hunt
    • 1
  • S. Stewart
    • 2
  • N. Cary
    • 2
  • T. Wreghitt
    • 4
  • T. Higenbottam
    • 4
  • J. Wallwork
    • 3
  1. 1.Department of PathologyPapworth HospitalCambridgeUK
  2. 2.Department of Respiratory PhysiologyPapworth HospitalCambridgeUK
  3. 3.Department of SurgeryPapworth HospitalCambridgeUK
  4. 4.Department of VirologyAddenbrooke’s HospitalCambridgeUK

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