Heart failure & cardiomyopathies
Failing to Make the Grade: Conventional Cardiac Allograft Rejection Grading Criteria Are Inadequate for Predicting Rejection Severity
Authors' conclusion
Conventional endomyocardial samples contain morphological information that enables accurate identification of clinically evident rejection events, and this information is incompletely captured by the current, guideline-endorsed, rejection grading criteria.
Study context
- Population
- Endomyocardial biopsy images from heart transplant recipients
- Participants
- 2,900 biopsy images
- Comparison
- Quantitative morphology features vs conventional ISHLT rejection grades
Methodological detailsquantitative image analysis, machine learning, 370 quantitative morphology features (lymphocytes and stroma) extracted per slide, Proof-of-principle machine learning pipeline (cardiac allograft rejection evaluator) developed
- Quantitative image analysis
- Machine learning
- 370 quantitative morphology features (lymphocytes and stroma) extracted per slide
- Proof-of-principle machine learning pipeline (cardiac allograft rejection evaluator) developed
Performance
As reported in the abstract
- Histopathologic findings associated with conventional rejection grades differ substantially from those associated with clinically evident allograft injury
- A small set of quantitative morphological features reflects rejection severity more accurately than ISHLT grades
Original publication
Failing to Make the Grade: Conventional Cardiac Allograft Rejection Grading Criteria Are Inadequate for Predicting Rejection Severity. Circ Heart Fail. Published 13 February 2024. doi:10.
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