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Severe cardiac allograft dysfunction without endomyocardial biopsy signs of cellular rejection: incidence and management.

Abstract：

:Acute dysfunction of cardiac allograft without evidence of cellular rejection is a potentially fatal complication of heart transplantation that suggests a humoral origin. In clinical practice, humoral rejection (HR) is suspected when there is evidence of severe allograft dysfunction but endomyocardial biopsy (EMB) shows no evidence of cellular rejection. Between April 1991 and August 2003, 12 patients (2.74%) among 438 heart transplants displayed this condition. Time post-heart transplant (HT) was 21.3 +/- 24.7 months (range 2 to 72 months). Immunofluorescence studies using classic markers were negative. All patients were treated with methylprednisolone "bolus" and plasmapheresis until clinical recovery, after which their immunosuppressive regimens were modified. Eleven of the 12 patients recovered satisfactory allograft function. In this series the incidence of suspected HR was low. Unlike other studies, we observed HR not only soon but also even years after HT. Plasmapheresis seems to be an effective treatment.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Veiga Barreiro A,Crespo Leiro M,Doménech García N,Paniagua MJ,Vázquez Martul E,González Cuesta M,Ramírez C,Juffé Stein A,Castro Beiras A

doi

10.1016/j.transproceed.2004.03.033

subject

Has Abstract

pub_date

2004-04-01 00:00:00

pages

778-9

issue

3

eissn

0041-1345

issn

1873-2623

pii

S0041134504002921

journal_volume

36

pub_type

杂志文章

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