Acute cellular rejection (ACR) in lung transplant recipients is diagnosed by identifying perivascular cellularity (PVC) from alveolar tissue typically obtained via invasive transbronchial biopsies. This study compared in vivo real-time histological imaging using Cellvizio for the identification of alveolar, vascular, and cellular microstructures of lung transplants to transbronchial biopsies. The prospective, multi-center study enrolled 24 patients who had undergone a lung transplant within the prior 12 months and who were scheduled for diagnostic biopsies. The study showed that pCLE identification of PVC is a feasible and reproducible criterion for assessment of acute cellular rejection in vivo. The PVC criterion exhibited a perfect sensitivity for the ACR diagnosis for a pCLE-trained pneumologist.
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