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A system for grading cardiac allograft rejection.

DURING THE endomyocardial biopsy procedure, four to eight pieces of endomyocardium are obtained from the right ventricular septum. These range from 1 to 4 mm in maximum dimension. This number of biopsy specimens reduces the possibility of false negative biopsies due to sampling error or false positive biopsies due to inflamed previous biopsy sites and increases the accuracy of biopsy grading over what one would obtain by evaluating a single biopsy specimen. For light microscopic evaluation, the biopsy specimens are fixed in 10% buffered formalin and processed for paraffin embedding. The usual fixation time is 2 hours. Following fixation, tissue processing is expedited by using a rapid tissue processor. Multiple sections of the specimens are subsequently prepared. The sections on two slides are stained with Hematoxylin and Eosin, and the sections on a third slide are stained with Masson Trichrome. The evaluation of the degree of cardiac allograft rejection is based on examination of the slides stained with Hematoxylin and Eosin. The Masson Trichrome stain is used as