PROSPECTIVE EVALUATION OF ECHOCARDIOGRAPHY FOR PRIMARY REJECTION SURVEILLANCE AFTER INFANT HEART-TRANSPLANTATION - COMPARISON WITH ENDOMYOCARDIAL BIOPSY

Rejection surveillance is critical to successful heart transplantation , and infant recipients have necessitated the use of noninvasive measu res. The survival, incidence of rejection, and accuracy of echocardiog raphy in predicting treatable rejection, as detected on right ventricu lar endomyocardial biopsy, were prospectively studied in infants. The survival rate (82%) and rejection rate (1.4 rejection episodes per 100 patient days) of infants who underwent transplantation during the stu dy were comparable to other studies that used heart biopsy only. Echoc ardiography was 98% accurate at predicting biopsy results. The sensiti vity of echocardiography was 92%, and the specificity was 98%. We conc lude that echocardiography can be used successfully for primary reject ion surveillance in infants and that right ventricular biopsy is infre quently required.