Faisal Mahmood & Eric J Topol –

For more than four decades, the monitoring of cardiac allograft rejection (CAR) has been achieved by surveillance endomyocardial biopsies (EMBs) and manual assessment by cardiac pathology experts. The first criteria for histological assessment of EMBs were devised during the 1970s, and the International Society for Heart and Lung Transplantation (ISHLT) developed standardised guidelines in the 1990s that have been frequently updated. Besides rejection, these guidelines also pertain to the subtype of rejection (cellular or antibody) and CAR severity. The interpretation of EMBs has major implications for the use of immunosuppressive drugs, the need for more frequent biopsies, and the outcome for patients.

Read the full article in The Lancet.