Confocal Scanning Microscopy in Assessment of Cardiac Allograft Rejection--A Pilot Study
R White1, D J Crossman2, M Isaacson2
1Cardiology, Auckland District Health Board, Auckland City Hospital, Park Road, Grafton, Private Bag 92024, Auckland 1030, New Zealand.
Transplantation Proceedings
|November 1, 2015
Summary
Confocal microscopy offers high-resolution imaging for cardiac allograft rejection, potentially improving diagnosis by revealing detailed cellular features in biopsies. This advanced technique may enhance the accuracy of grading cardiac rejection.
Area of Science:
- Cardiology
- Pathology
- Microscopy
Background:
- Cardiac allograft rejection diagnosis relies on H&E histology of endomyocardial biopsies.
- Pathologist grading of rejection shows considerable variability.
- Confocal microscopy offers high contrast and resolution imaging for detailed pathological views.
Purpose of the Study:
- To determine if confocal microscopy can detect features of cardiac allograft rejection.
- To explore confocal microscopy's potential in improving rejection assessment.
Main Methods:
- Collected additional samples from 30 heart transplant patient biopsies.
- Imaged samples using confocal microscopy after fluorescent labeling (DAPI, WGA, phalloidin).
- Visualized cell nuclei, cell borders, extracellular matrix, and muscle cell actin.
Main Results:
- Confocal imaging revealed high-resolution features: perivascular/interstitial infiltrate, myocyte damage, and Quilty lesions.
- Detailed views of myocyte damage showed myofilament distortion, aiding distinction between 1R and 2R grades.
- High-contrast fluorescent labeling was achieved, though some variability in DAPI and phalloidin labeling was noted.
Conclusions:
- Confocal microscopy provides high-contrast, high-resolution imaging of cardiac biopsies.
- This technique has the potential to aid in the assessment of cardiac allograft rejection.
- Further exploration of confocal microscopy could improve diagnostic accuracy and reduce inter-pathologist variability.
