In situ hybridization studies for viral nucleic acids in heart and lung allograft biopsies

In situ hybridization has been shown to be a useful technique for the identification of specific viruses in pathologic tissues. The authors studied 313 lung and 164 heart biopsies from 20 heart-lung recipients to assess its utility in this clinical setting, employing biotinylated probes for the cytomegalovirus, herpes simplex, and adenovirus genomes. Twenty-five lung biopsies and one heart biopsy had detectable cytomegalovirus DNA by in situ hybridization. As compared to histopathology, in situ hybridization had a sensitivity of 85% and a specificity of 99%. None of the biopsies had detectable herpes simplex or adenovirus by either in situ hybridization or routine histopathology. In situ hybridization studies may be of greatest use when the results of conventional histopathology are equivocal and in the patients with radiologic or clinical evidence of pulmonary disease.