The Heart transplant rejection pathology

English

  • Andrea Stojićević University of Belgrade, Faculty of Medicine, Institute for Pathology "Dr. Djordje Jovanović", Belgrade, Serbia
  • Milena Jovanović University of Belgrade, Faculty of Medicine, Institute for Pathology "Dr. Djordje Jovanović", Belgrade, Serbia
  • Miloš Matković University Clinical Center of Serbia, Clinic for Cardiovascular Surgery, Belgrade, Serbia
  • Emilija Nestorović University Clinical Center of Serbia, Clinic for Cardiovascular Surgery, Belgrade, Serbia
  • Nemanja Stanojević University of Belgrade, Faculty of Medicine, Institute for Pathology "Dr. Djordje Jovanović", Belgrade, Serbia
  • Branko Dožić University of Belgrade, Faculty of Dental Medicine, Department of Pathology, Belgrade, Serbia
  • Sofija Glumac University of Belgrade, Faculty of Medicine, Institute for Pathology "Dr. Djordje Jovanović", Belgrade, Serbia
Keywords: biopsy;, heart;, heart function tests;, heart transplantation;, histological techniques;, immunohistochemistry;, organ dysfunction scores.

Abstract


Background/Aim. Heart transplantation is the most effective way to treat patients in the terminal stage of heart failure. Endomyocardial biopsy has proven to be a safe and appropriate technique, with little sampling error, and remains, to this day, one of the most commonly used methods for diagnosing acute rejection. In 1990, the International Society of Heart and Lung Transplantation defined a standardized system for grading the severity of acute transplant rejection regarding endomyocardial sampling histopathological analysis. The aim of the study was to assess the morphological, immunohistochemical, and immunofluorescent markers of cell- and antibody-mediated rejection of heart transplants in patients monitored during 2020. Methods. From 31 patients transplanted at the Clinic for Cardiac Surgery of the University Clinical Center of Serbia, endomyocardial biopsy material was obtained, then processed and analyzed at the Institute of Pathology of the Faculty of Medicine, University of Belgrade. Results. The average Transplant Rejection Score (TRS) value was 0.42. The Spearman's correlation test did not show a statistically significant relationship between the TRS value and the difference between the ejection fraction values three and twelve months after transplantation. Conclusion. The mean TRS value obtained in this study suggests dominant cell-mediated graft rejection.

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Published
2022/12/23
Section
Original Paper