Prospective Study of Comparison between Transbronchial Forceps Biopsy and Cryoprobe in the Diagnosis of Acute Rejection after Lung Transplantation

Purpose Transbronchial biopsy (TBB) using forceps is the standard procedure to establish the presence of allograft rejection after lung transplantation. However, inadequate tissue samples, high degree of interobservers variability and possible complications seems to prevent many centers in scheduling TBB in lung transplant follow-up.We aimed to compare histological quality of cryobiopsy (CB) and conventional forceps biopsy (FB) for sampling lung tissue in transplants recipients. Methods Eligible for inclusion were adults subjected to scheduled transbronchial biopsy at 3, 6 and 12 months after lung transplantation. A single pathologist classified the biopsy according to ISHLT scale.From January 2019 to August 2020, 54 consecutive transbronchial lung biopsies procedures were included in the study. All patients underwent at least 6 biopsies with forceps and 3 with cryoprobe in the same lung lobe. Clinical, functional data and histological findings were collected. Results The diagnostic yield of acute rejection using cryobiopsy is 100% compared to 79% using biopsy forceps. The difference in proportion is 0.20 [95% C.I: 0,11-0,29, p Conclusion Transbronchial cryobiopsy is effective for diagnosis of lung allograft rejection because it provides larger and more diagnostic lung parenchyma specimens than traditional forceps biopsies.