Clinical Diagnostic Applications of the Polymerase Chain Reaction

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Abstract
In this review, we describe the power and sensitivity of the polymerase chain reaction and indicate areas of clinical medicine in which it is currently being applied. As this technology and automation improves and is simplified, its realm of application will expand, but its major impact will continue to be its facilitation of early, specific diagnoses in infectious disease, genetics, cancer, and transplantation. Polymerase chain reaction is currently most useful in the care of opportunistic infections in immunosuppressed hosts and in making the distinction between infection and rejection in transplant recipients. As the technique becomes more widely available and less costly, its application should minimize the need for broad-spectrum antibiotic therapy of infections, lower costs, and perhaps even shorten hospitalization. These potential beneficial effects of polymerase chain reaction will be particularly relevant in the current cost-conscious health-care environment. (Arch Surg. 1993;128:1253-1259)