|
Standardized Cardiac Biopsy Grading |
| Grade |
Histopathological Findings |
| 0 |
No rejection |
| 1 (1A or 1B) |
A = Focal (perivascular or interstitial) infiltrate without necrosis
|
| B = Diffuse but sparse infiltrate without necrosis |
| 2 |
One focus only with aggressive infiltration and/or focal
myocyte damage |
| 3 (3A or 3B) |
A = Multifocal aggressive infiltrates and/or myocyte
damage |
| B = Diffuse inflammatory process with necrosis |
| 4 |
Diffuse aggressive polymorphous ± infiltrate ± edema,
± hemorrhage, ± vasculitis, with necrosis |
Additional Required Information* |
-
Biopsy less than 4 pieces
|
-
Humoral rejection (positive IF, vasculitis, or severe edema in absence
of cellular infiltrate
|
-
"Quilty" effect (Type A or Type B)
|
A = No myocyte encroachment |
| B = With myocyte encroachment |
|
A = Up to 3 weeks posttransplant |
| B = Late ischemia |
-
Infection present - biopsy therefore uninterpretable
|
|
|
|
* Must be added to biopsy report if present
|
|
Reference
Billingham ME, et al. A working formulation for the
standardization of nomenclature in the diagnosis of heart and lung
rejection: heart rejection study group.
J Heart Trans 1990;9(6):587-93.
|
