Transition from Transbronchial Forceps to Cryobiopsy After Lung Transplantation: A Single-Centre Experience
The gold standard for histological acute cellular rejection diagnosis is transbronchial forceps biopsy (FB), but in recent years, transbronchial cryobiopsy (CB) has been increasingly used. This study aims to compare the diagnostic rate and safety of FBs and CBs performed in two different periods. We...
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MDPI AG
2024-11-01
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| author | Davide Tosi Margherita Brivio Sara Franzi Alessandro Palleschi Gianluca Bonitta Gianluca Lopez Ilaria Righi Paolo Mendogni Margherita Cattaneo Francesco Damarco Letizia Morlacchi Valeria Rossetti Lorenzo Rosso |
| author_facet | Davide Tosi Margherita Brivio Sara Franzi Alessandro Palleschi Gianluca Bonitta Gianluca Lopez Ilaria Righi Paolo Mendogni Margherita Cattaneo Francesco Damarco Letizia Morlacchi Valeria Rossetti Lorenzo Rosso |
| author_sort | Davide Tosi |
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| description | The gold standard for histological acute cellular rejection diagnosis is transbronchial forceps biopsy (FB), but in recent years, transbronchial cryobiopsy (CB) has been increasingly used. This study aims to compare the diagnostic rate and safety of FBs and CBs performed in two different periods. We retrospectively reviewed our case history for the two biopsy procedures: 251 FBs (223 for surveillance purposes and 28 for clinical indication) and 218 consecutive CBs (159 for surveillance purposes and 59 for clinical indication). All biopsies were scored according to the ISHLT criteria. Diagnostic yield was higher in the CB group for all the parameters considered: a grade of acute rejection (AR) was detected in 95.0% vs. 84.5% in the CB vs. FB groups (<i>p</i> < 0.001). The diagnostic rate of airway inflammation was 65.1% vs. 51.8% (<i>p</i> = 0.005), and 89.0% vs. 64.9% (<i>p</i> < 0.001) for chronic rejection. Pneumothorax requiring chest drainage occurred in 4% of the CB group and 3% of the FB group. Moderate and severe bleeding complicated CB and FB procedures in seven (3%) and three cases (1%), respectively. Transbronchial cryobiopsies improved the diagnostic yield in the monitoring of the lung allograft. The complication rate did not increase significantly in CBs vs. FBs. |
| format | Article |
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| issn | 2075-1729 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
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| series | Life |
| spelling | doaj-art-d8bf21b8f59a4f03b5f8ec90302f1e0f2025-08-20T02:05:03ZengMDPI AGLife2075-17292024-11-011411147410.3390/life14111474Transition from Transbronchial Forceps to Cryobiopsy After Lung Transplantation: A Single-Centre ExperienceDavide Tosi0Margherita Brivio1Sara Franzi2Alessandro Palleschi3Gianluca Bonitta4Gianluca Lopez5Ilaria Righi6Paolo Mendogni7Margherita Cattaneo8Francesco Damarco9Letizia Morlacchi10Valeria Rossetti11Lorenzo Rosso12Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyThoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyThoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyThoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyDepartment of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 12, 20122 Milan, ItalyDivision of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyThoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyThoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyThoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyThoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyDepartment of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 12, 20122 Milan, ItalyRespiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyThoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyThe gold standard for histological acute cellular rejection diagnosis is transbronchial forceps biopsy (FB), but in recent years, transbronchial cryobiopsy (CB) has been increasingly used. This study aims to compare the diagnostic rate and safety of FBs and CBs performed in two different periods. We retrospectively reviewed our case history for the two biopsy procedures: 251 FBs (223 for surveillance purposes and 28 for clinical indication) and 218 consecutive CBs (159 for surveillance purposes and 59 for clinical indication). All biopsies were scored according to the ISHLT criteria. Diagnostic yield was higher in the CB group for all the parameters considered: a grade of acute rejection (AR) was detected in 95.0% vs. 84.5% in the CB vs. FB groups (<i>p</i> < 0.001). The diagnostic rate of airway inflammation was 65.1% vs. 51.8% (<i>p</i> = 0.005), and 89.0% vs. 64.9% (<i>p</i> < 0.001) for chronic rejection. Pneumothorax requiring chest drainage occurred in 4% of the CB group and 3% of the FB group. Moderate and severe bleeding complicated CB and FB procedures in seven (3%) and three cases (1%), respectively. Transbronchial cryobiopsies improved the diagnostic yield in the monitoring of the lung allograft. The complication rate did not increase significantly in CBs vs. FBs.https://www.mdpi.com/2075-1729/14/11/1474lung transplantationacute cellular rejectionchronic rejectionendoscopic surveillancetransbronchial biopsycryobiopsy |
| spellingShingle | Davide Tosi Margherita Brivio Sara Franzi Alessandro Palleschi Gianluca Bonitta Gianluca Lopez Ilaria Righi Paolo Mendogni Margherita Cattaneo Francesco Damarco Letizia Morlacchi Valeria Rossetti Lorenzo Rosso Transition from Transbronchial Forceps to Cryobiopsy After Lung Transplantation: A Single-Centre Experience Life lung transplantation acute cellular rejection chronic rejection endoscopic surveillance transbronchial biopsy cryobiopsy |
| title | Transition from Transbronchial Forceps to Cryobiopsy After Lung Transplantation: A Single-Centre Experience |
| title_full | Transition from Transbronchial Forceps to Cryobiopsy After Lung Transplantation: A Single-Centre Experience |
| title_fullStr | Transition from Transbronchial Forceps to Cryobiopsy After Lung Transplantation: A Single-Centre Experience |
| title_full_unstemmed | Transition from Transbronchial Forceps to Cryobiopsy After Lung Transplantation: A Single-Centre Experience |
| title_short | Transition from Transbronchial Forceps to Cryobiopsy After Lung Transplantation: A Single-Centre Experience |
| title_sort | transition from transbronchial forceps to cryobiopsy after lung transplantation a single centre experience |
| topic | lung transplantation acute cellular rejection chronic rejection endoscopic surveillance transbronchial biopsy cryobiopsy |
| url | https://www.mdpi.com/2075-1729/14/11/1474 |
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