JHLT open · 2025
Transbronchial cryobiopsy alone versus combined with traditional forceps biopsy for acute cellular rejection in lung transplant recipients. A diagnostic randomized trial.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Steinack Carolin, Roeder Maurice, Vesenbeckh Silvan, Haberecker Martina, Rüschoff Jan H, Hage René, Ulrich Silvia, Kohler Malcolm, Schuurmans Macé M, Franzen Daniel P, Gaisl Thomas
Аннотация
BACKGROUND: Transbronchial lung biopsy is routinely performed to identify acute cellular rejection (ACR) in lung transplant recipients (LTRs). This trial evaluates the clinical value of forceps and cryobiopsies versus cryobiopsies as a standalone diagnostic tool.
METHODS: In this randomized trial, LTRs were randomly assigned to receive either 2 cryobiopsies (cryobiopsy group) or a combination of 5 forceps- and 2 cryobiopsies (combined group). The primary outcome was the diagnostic yield to detect ACR; the secondary outcome was the incidence of ACR. We conducted a paired, intraindividual comparison in the combined group alongside interindividual comparisons.
RESULTS: A total of 80 LTRs were randomly assigned to the cryobiopsy group (n = 40) or the combined group (n = 40) with 90 and 87 procedures performed, respectively. The diagnostic yield for ACR in the cryobiopsy group was similar to the combined group (95.6% vs 97.7%, p = 0.430). The sole use of cryobiopsies did not lead to a lower ACR incidence compared to the combined group (10% vs 17.2%, risk ratio 2.21 [95% confidence interval (CI) 0.67-7.29]; p = 0.190). Adverse events did not differ between the 2 groups (60.9% vs 57.5%, p = 0.655). The pneumothorax rate was overall 1.7%. There were no deaths or occurrences of severe bleeding.
CONCLUSIONS: Cryobiopsies did not detect lower ACR than the combined group and can be used as primary and standalone diagnostic tools for histologic assessment of ACR without requiring forceps biopsies.
METHODS: In this randomized trial, LTRs were randomly assigned to receive either 2 cryobiopsies (cryobiopsy group) or a combination of 5 forceps- and 2 cryobiopsies (combined group). The primary outcome was the diagnostic yield to detect ACR; the secondary outcome was the incidence of ACR. We conducted a paired, intraindividual comparison in the combined group alongside interindividual comparisons.
RESULTS: A total of 80 LTRs were randomly assigned to the cryobiopsy group (n = 40) or the combined group (n = 40) with 90 and 87 procedures performed, respectively. The diagnostic yield for ACR in the cryobiopsy group was similar to the combined group (95.6% vs 97.7%, p = 0.430). The sole use of cryobiopsies did not lead to a lower ACR incidence compared to the combined group (10% vs 17.2%, risk ratio 2.21 [95% confidence interval (CI) 0.67-7.29]; p = 0.190). Adverse events did not differ between the 2 groups (60.9% vs 57.5%, p = 0.655). The pneumothorax rate was overall 1.7%. There were no deaths or occurrences of severe bleeding.
CONCLUSIONS: Cryobiopsies did not detect lower ACR than the combined group and can be used as primary and standalone diagnostic tools for histologic assessment of ACR without requiring forceps biopsies.