Handling and interpretation of lung transplant biopsies

The transbronchial biopsy is the gold standard for evaluation of rejection in the lung allograft. The biopsy is an invasive procedure that produces small quantities of tissue that is prone to crush artifact and is often suboptimal for evaluation. Furthermore, the biopsies should contain both alveolar tissue and airway wall to be considered adequate. Therefore, it is essential that the tissue is carefully handled at all stages of tissue processing and evaluation to ensure the best evaluation in a time sensitive and cost effective manner. Herein we describe an optimized protocol for handling and interpreting lung transplant biopsies.