{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T09:21:24Z","timestamp":1753521684656},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1994,5]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND<\/jats:title>\n            <jats:p>Acute rejection may be suspected in heart transplant recipients in the setting of new onset of clinical symptoms or alterations in cardiac function. Immediate diagnosis may be obtained by performing a frozen section on endomyocardial biopsy (EMB) specimens. However, little is known about the indications for, and the diagnostic reliability of, this procedure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS AND RESULTS<\/jats:title>\n            <jats:p>EMBs with frozen section (n = 98) from 65 of 214 consecutive orthotopic heart transplant recipients were reviewed and divided into early (&lt; or = 45 days; n = 47) and late (&gt; 45 days; n = 51) posttransplant periods. Frozen section diagnoses (means = 1.5 EMB samples) were compared with corresponding permanent section diagnoses (means = 4.4 EMB samples), and clinical indications were analyzed. Comparison of frozen and permanent section interpretation revealed concordant pathological processes-rejection (n = 31) versus no rejection (n = 37) versus ischemic injury (n = 20)-in 88 of 98 (90%) cases. Discordant pathological processes on frozen versus permanent section in 10 of 98 (10%) cases could be attributed to ischemic injury (n = 5), sampling (n = 4), and infection (n = 1). In the 92 cases with defined clinical indications, the indication and number of EMBs positive for rejection early and late after transplantation were arrhythmia: 2 of 12 early, 4 of 10 late; congestive heart failure: 1 of 2 early, 5 of 12 late; fever: 0 of 2 early, 1 of 4 late; echo abnormality: 0 of 5 early, 0 of 1 late; syncope: 1 of 5 early, 0 of 1 late; hypotension: 1 of 3 early, 1 of 2 late; noncompliance: 0 of 0 early, 4 of 5 late; more than one of the above: 3 of 7 early, 2 of 5 late; other: 1 of 7 early, 1 of 9 late; total: 9 of 43 early, 18 of 49 late.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS<\/jats:title>\n            <jats:p>Frozen section on EMB specimens accurately reflected the permanent section diagnosis in 90% of cases. No specific clinical indication predicted EMB rejection positivity with high sensitivity in either the early or late posttransplant periods.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/01.cir.89.5.2079","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:34:42Z","timestamp":1339461282000},"page":"2079-2084","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Immediate evaluation of endomyocardial biopsies for clinically suspected rejection after heart transplantation."],"prefix":"10.1161","volume":"89","author":[{"given":"G L","family":"Winters","sequence":"first","affiliation":[{"name":"Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P J","family":"Hauptman","sequence":"additional","affiliation":[{"name":"Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J A","family":"Jarcho","sequence":"additional","affiliation":[{"name":"Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F J","family":"Schoen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/pdf\/10.1161\/01.CIR.89.5.2079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T15:35:55Z","timestamp":1715528155000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.89.5.2079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,5]]},"references-count":0,"journal-issue":{"issue":"5","published-print":{"date-parts":[[1994,5]]}},"alternative-id":["10.1161\/01.CIR.89.5.2079"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.89.5.2079","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1994,5]]},"assertion":[{"value":"1994-05-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}