Skip to main content Accessibility help
Hostname: page-component-77c89778f8-n9wrp Total loading time: 0 Render date: 2024-07-18T17:40:55.087Z Has data issue: false hasContentIssue false

Chapter 4 - The Pathology of Heart Transplantation

Published online by Cambridge University Press:  17 March 2018

Phillip Ruiz
University of Miami School of Medicine
Get access
Publisher: Cambridge University Press
Print publication year: 2018

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Lund, LH, Edwards, LB, Kucheryavaya, AY, Dipchand, AI, Benden, C, Christie, JD, et al. The Registry of the International Society for Heart and Lung Transplantation: Thirtieth Official Adult Heart Transplant Report-2013; Focus Theme: Age. J Heart Lung Transplant. 2013;32(10):951–64.Google Scholar
Dipchand, AI, Kirk, R, Edwards, LB, Kucheryavaya, AY, Benden, C, Christie, JD, et al. The Registry of the International Society for Heart and Lung Transplantation: Sixteenth Official Pediatric Heart Transplantation Report-2013; Focus Theme: Age. J Heart Lung Transplant. 2013;32(10):979–88.Google Scholar
Zerbe, TR, Arena, V. Diagnostic Reliability of Endomyocardial Biopsy for Assessment of Cardiac Allograft Rejection. Hum Pathol. 1988;19(11):1307–14.Google Scholar
Wagner, K, Oliver, MC, Boyle, GJ, Miller, SA, Law, YM, Pigula, F, et al. Endomyocardial Biopsy in Pediatric Heart Transplant Recipients: A Useful Exercise? (Analysis of 1,169 Biopsies). Pediatr Transplant. 2000;4(3):186–92.Google Scholar
Mehra, MR, Uber, PA, Uber, WE, Park, MH, Scott, RL. Anything but a Biopsy: Noninvasive Monitoring for Cardiac Allograft Rejection. Curr Opin Cardiol. 2002;17(2):131–6.Google Scholar
Balzer, D, Moorhead, S, Saffitz, JE, Sekarski, DR, Canter, CE. Pediatric Endomyocardial Biopsy Performed Solely with Echocardiographic Guidance. J Am Soc Echocardiogr. 1993;6(5):510–5.CrossRefGoogle ScholarPubMed
Pomerance, A, Stovin, PG. Heart Transplant Pathology: The British Experience. Journal of Clinical Pathology. 1985;38(2):146–59.CrossRefGoogle ScholarPubMed
Spiegelhalter, DJ, Stovin, PG. An Analysis of Repeated Biopsies Following Cardiac Transplantation. Statistics in Medicine. 1983;2(1):3340.Google Scholar
Sharples, LD, Cary, NR, Large, SR, Wallwork, J. Error Rates with which Endomyocardial Biopsy Specimens Are Graded for Rejection after Cardiac Transplantation. Am J Cardiol. 1992;70(4):527–30.CrossRefGoogle ScholarPubMed
Billingham, ME, Cary, NR, Hammond, ME, Kemnitz, J, Marboe, C, McCallister, HA, et al. A Working Formulation for the Standardization of Nomenclature in the Diagnosis of Heart and Lung Rejection: Heart Rejection Study Group. The International Society for Heart Transplantation. J Heart Transplant. 1990;9(6):587–93.Google Scholar
Stewart, S, Winters, GL, Fishbein, MC, Tazelaar, HD, Kobashigawa, J, Abrams, J, et al. Revision of the 1990 Working Formulation for the Standardization of Nomenclature in the Diagnosis of Heart Rejection. J Heart Lung Transplant. 2005;24(11):1710–20.CrossRefGoogle ScholarPubMed
Wiklund, L, Suurkula, MB, Kjellstrom, C, Berglin, E. Chordal Tissue in Endomyocardial Biopsies. Scandinavian Journal of Thoracic and Cardiovascular Surgery. 1994;28(1):13–8.Google Scholar
Rodriguez, ER, International Society for H, Lung T. The Pathology of Heart Transplant Biopsy Specimens: Revisiting the 1990 ISHLT Working Formulation. J Heart Lung Transplant. 2003;22(1):315.Google Scholar
Reed, EF, Demetris, AJ, Hammond, E, Itescu, S, Kobashigawa, JA, Reinsmoen, NL, et al. Acute Antibody-mediated Rejection of Cardiac Transplants. J Heart Lung Transplant. 2006;25(2):153–9.Google Scholar
Berry, GJ, Angelini, A, Burke, MM, Bruneval, P, Fishbein, MC, Hammond, E, et al. The ISHLT Working Formulation for Pathologic Diagnosis of Antibody-mediated Rejection in Heart Transplantation: Evolution and Current Status (2005–2011). J Heart Lung Transplant. 2011;30(6):601–11.Google Scholar
Berry, GJ, Burke, MM, Andersen, C, Bruneval, P, Fedrigo, M, Fishbein, MC, et al. The 2013 International Society for Heart and Lung Transplantation Working Formulation for the Standardization of Nomenclature in the Pathologic Diagnosis of Antibody-mediated Rejection in Heart Transplantation. J Heart Lung Transplant. 2013;32(12):1147–62.Google Scholar
Rose, AG, Cooper, DK, Human, PA, Reichenspurner, H, Reichart, B. Histopathology of Hyperacute Rejection of the Heart: Experimental and Clinical Observations in Allografts and Xenografts. J Heart Lung Transplant. 1991;10(2):223–34.Google ScholarPubMed
Schuurman, HJ, Gmelig Meyling, FH, Wijngaard, PL, Van der Meulen, A, Slootweg, PJ, Jambroes, G. Lymphocyte Status in Endomyocardial Biopsies and Blood after Heart Transplantation. J Pathol. 1989;159(3):197203.CrossRefGoogle ScholarPubMed
van Besouw, NM, Balk, AH, Mochtar, B, Vaessen, LM, Weimar, W. Phenotypic Analysis of Lymphocytes Infiltrating Human Cardiac Allografts during Acute Rejection and the Development of Graft Vascular Disease. Transpl Int. 1996;9 Suppl 1:S2346.Google Scholar
Higuchi, ML, de Assis, RV, Sambiase, NV, Reis, MM, Kalil, J, Bocchi, E, et al. Usefulness of T-cell Phenotype Characterization in Endomyocardial Biopsy Fragments from Human Cardiac Allografts. J Heart Lung Transplant. 1991;10(2):235–42.Google Scholar
Ibrahim, S, Dawson, DV, Van Trigt, P, Sanfilippo, F. Differential Infiltration by CD45RO and CD45RA Subsets of T Cells Associated with Human Heart Allograft Rejection. Am J Pathol. 1993;142(6):1794–803.Google Scholar
Mues, B, Brisse, B, Steinhoff, G, Lynn, T, Hewett, T, Sorg, C, et al. Diagnostic Assessment of Macrophage Phenotypes in Cardiac Transplant Biopsies. Eur Heart J. 1991;12 Suppl D:32–5.Google Scholar
Hoshinaga, K, Mohanakumar, T, Goldman, MH, Wolfgang, TC, Szentpetery, S, Lee, HM, et al. Clinical Significance of in Situ Detection of T Lymphocyte Subsets and Monocyte/Macrophage Lineages in Heart Allografts. Transplantation. 1984;38(6):634–7.CrossRefGoogle ScholarPubMed
Gassel, AM, Hansmann, ML, Radzun, HJ, Weyand, M. Human Cardiac Allograft Rejection. Correlation of Grading with Expression of Different Monocyte/Macrophage Markers. Am J Clin Pathol. 1990;94(3):274–9.Google Scholar
Sorrentino, C, Scarinci, A, D’Antuono, T, Piccirilli, M, Di Nicola, M, Pasquale, M, et al. Endomyocardial Infiltration by B and NK Cells Foreshadows the Recurrence of Cardiac Allograft Rejection. The Journal of Pathology. 2006;209(3):400–10.Google Scholar
Takahashi, H, Ruiz, P, Ricordi, C, Delacruz, V, Miki, A, Mita, A, et al. Quantitative in Situ Analysis of FoxP3+ T Regulatory Cells on Transplant Tissue Using Laser Scanning Cytometry. Cell Transplant. 2012;21(1):113–25.CrossRefGoogle ScholarPubMed
Fyfe, B, Loh, E, Winters, GL, Couper, GS, Kartashov, AI, Schoen, FJ. Heart Transplantation-associated Perioperative Ischemic Myocardial Injury. Morphological Features and Clinical Significance. Circulation. 1996;93(6):1133–40.Google Scholar
Kottke-Marchant, K, Ratliff, NB. Endomyocardial Lymphocytic Infiltrates in Cardiac Transplant Recipients. Incidence and Characterization. Arch Pathol Lab Med. 1989;113(6):690–8.Google Scholar
Joshi, A, Masek, MA, Brown, BW Jr., Weiss, LM, Billingham, ME. “Quilty” Revisited: A 10-year Perspective. Hum Pathol. 1995;26(5):547–57.CrossRefGoogle ScholarPubMed
Luthringer, DJ, Yamashita, JT, Czer, LS, Trento, A, Fishbein, MC. Nature and Significance of Epicardial Lymphoid Infiltrates in Cardiac Allografts. J Heart Lung Transplant. 1995;14(3):537–43.Google Scholar
Tan, CD, Baldwin, WM, 3rd, Rodriguez, ER. Update on Cardiac Transplantation Pathology. Arch Pathol Lab Med. 2007;131(8):1169–91.Google Scholar
Suit, PF, Kottke-Marchant, K, Ratliff, NB, Pippenger, CE, Easely, K. Comparison of Whole-blood Cyclosporine Levels and the Frequency of Endomyocardial Lymphocytic Infiltrates (the Quilty Lesion) in Cardiac Transplantation. Transplantation. 1989;48(4):618–21.Google Scholar
Nakhleh, RE, Copenhaver, CM, Werdin, K, McDonald, K, Kubo, SH, Strickler, JG. Lack of Evidence for Involvement of Epstein-Barr Virus in the Development of the “Quilty” Lesion of Transplanted Hearts: An in Situ Hybridization Study. J Heart Lung Transplant. 1991;10(4):504–7.Google Scholar
Freimark, D, Czer, LS, Aleksic, I, Ruan, XM, Admon, D, Blanche, C, et al. Pathogenesis of Quilty Lesion in Cardiac Allografts: Relationship to Reduced Endocardial Cyclosporine A. J Heart Lung Transplant. 1995;14(6 Pt 1):1197–203.Google Scholar
Barone, JH, Fishbein, MC, Czer, LS, Blanche, C, Trento, A, Luthringer, DJ. Absence of Endocardial Lymphoid Infiltrates (Quilty Lesions) in Nonheart Transplant Recipients Treated with Cyclosporine. J Heart Lung Transplant. 1997;16(6):600–3.Google Scholar
Marboe, CC, Billingham, M, Eisen, H, Deng, MC, Baron, H, Mehra, M, et al. Nodular Endocardial Infiltrates (Quilty Lesions) Cause Significant Variability in Diagnosis of ISHLT Grade 2 and 3 A Rejection in Cardiac Allograft Recipients. J Heart Lung Transplant. 2005;24(7 Suppl):S21926.Google Scholar
Foerster, A, Simonsen, S, Froysaker, T. Heart Transplantation in Norway. Morphological Monitoring of Cardiac Allograft Rejection. A 3-year Follow-up. APMIS. 1988;96(1):1424.Google Scholar
Sibley, RK, Olivari, MT, Ring, WS, Bolman, RM. Endomyocardial Biopsy in the Cardiac Allograft Recipient. A Review of 570 Biopsies. Ann Surg. 1986;203(2):177–87.Google Scholar
Kemnitz, J, Cohnert, T, Schafers, HJ, Helmke, M, Wahlers, T, Herrmann, G, et al. A Classification of Cardiac Allograft Rejection. A Modification of the Classification by Billingham. Am J Surg Pathol. 1987;11(7):503–15.Google Scholar
Myles, JL, Ratliff, NB, McMahon, JT, Golding, LR, Hobbs, RE, Rincon, G, et al. Reversibility of Myocyte Injury in Moderate and Severe Acute Rejection in Cyclosporine-treated Cardiac Transplant Patients. Arch Pathol Lab Med. 1987;111(10):947–52.Google Scholar
Hammond, EH, Yowell, RL. Ultrastructural Findings in Cardiac Transplant Recipients. Ultrastruct Pathol. 1994;18(1–2):213–20.CrossRefGoogle ScholarPubMed
Hook, S, Caple, JF, McMahon, JT, Myles, JL, Ratliff, NB. Comparison of Myocardial Cell Injury in Acute Cellular Rejection versus Acute Vascular Rejection in Cyclosporine-treated Heart Transplants. J Heart Lung Transplant. 1995;14(2):351–8.Google Scholar
McMahon, JT, Ratliff, NB. Regeneration of Adult Human Myocardium after Acute Heart Transplant Rejection. J Heart Transplant. 1990;9(5):554–67.Google Scholar
Haddad, F, Deuse, T, Pham, M, Khazanie, P, Rosso, F, Luikart, H, et al. Changing Trends in Infectious Disease in Heart Transplantation. J Heart Lung Transplant. 2010;29(3):306–15.Google Scholar
Miller, LW, Naftel, DC, Bourge, RC, Kirklin, JK, Brozena, SC, Jarcho, J, et al. Infection after Heart Transplantation: A Multiinstitutional Study. Cardiac Transplant Research Database Group. J Heart Lung Transplant. 1994;13(3):381–92; discussion 93.Google Scholar
Smart, FW, Naftel, DC, Costanzo, MR, Levine, TB, Pelletier, GB, Yancy, CW Jr., et al. Risk Factors for Early, Cumulative, and Fatal Infections after Heart Transplantation: A Multiinstitutional Study. J Heart Lung Transplant. 1996;15(4):329–41.Google Scholar
Arbustini, E, Grasso, M, Diegoli, M, Percivalle, E, Grossi, P, Bramerio, M, et al. Histopathologic and Molecular Profile of Human Cytomegalovirus Infections in Patients with Heart Transplants. Am J Clin Pathol. 1992;98(2):205–13.Google ScholarPubMed
Holliman, R, Johnson, J, Savva, D, Cary, N, Wreghitt, T. Diagnosis of Toxoplasma Infection in Cardiac Transplant Recipients Using the Polymerase Chain Reaction. Journal of Clinical Pathology. 1992;45(10):931–2.Google Scholar
Wagner, FM, Reichenspurner, H, Uberfuhr, P, Weiss, M, Fingerle, V, Reichart, B. Toxoplasmosis after Heart Transplantation: Diagnosis by Endomyocardial Biopsy. J Heart Lung Transplant. 1994;13(5):916–8.Google Scholar
Drescher, J, Wagner, D, Haverich, A, Flik, J, Stachan-Kunstyr, R, Verhagen, W, et al. Nosocomial Hepatitis B Virus Infections in Cardiac Transplant Recipients Transmitted during Transvenous Endomyocardial Biopsy. The Journal of Hospital Infection. 1994;26(2):8192.Google Scholar
Fishman, JA, Rubin, RH, Koziel, MJ, Periera, BJ. Hepatitis C Virus and Organ Transplantation. Transplantation. 1996;62(2):147–54.Google Scholar
Breinholt, JP, Moulik, M, Dreyer, WJ, Denfield, SW, Kim, JJ, Jefferies, JL, et al. Viral Epidemiologic Shift in Inflammatory Heart Disease: The Increasing Involvement of Parvovirus B19 in the Myocardium of Pediatric Cardiac Transplant Patients. J Heart Lung Transplant. 2010;29(7):739–46.CrossRefGoogle ScholarPubMed
Peters, M, Schurmann, D, Mayr, AC, Heterzer, R, Pohle, HD, Ruf, B. Immunosuppression and Mycobacteria Other than Mycobacterium Tuberculosis: Results from Patients with and without HIV Infection. Epidemiology and Infection. 1989;103(2):293300.Google Scholar
Patel, R, Roberts, GD, Keating, MR, Paya, CV. Infections Due to Nontuberculous Mycobacteria in Kidney, Heart, and Liver Transplant Recipients. Clin Infect Dis. 1994;19(2):263–73.Google Scholar
LeMense, GP, VanBakel, AB, Crumbley, AJ, 3rd, Judson, MA. Mycobacterium Scrofulaceum Infection Presenting as Lung Nodules in a Heart Transplant Recipient. Chest. 1994;106(6):1918–20.Google Scholar
Morio, F, Treilhaud, M, Lepelletier, D, Le Pape, P, Rigal, JC, Delile, L, et al. Aspergillus Fumigatus Endocarditis of the Mitral Valve in a Heart Transplant Recipient: A Case Report. Diagn Microbiol Infect Dis. 2008;62(4):453–6.Google Scholar
Zaoutis, TE, Webber, S, Naftel, DC, Chrisant, MA, Kaufman, B, Pearce, FB, et al. Invasive Fungal Infections in Pediatric Heart Transplant Recipients: Incidence, Risk Factors, and Outcomes. Pediatr Transplant. 2011;15(5):465–9.Google Scholar
Almyroudis, NG, Sutton, DA, Linden, P, Rinaldi, MG, Fung, J, Kusne, S. Zygomycosis in Solid Organ Transplant Recipients in a Tertiary Transplant Center and Review of the Literature. Am J Transplant. 2006;6(10):2365–74.Google Scholar
Montoya, JG, Giraldo, LF, Efron, B, Stinson, EB, Gamberg, P, Hunt, S, et al. Infectious Complications among 620 Consecutive Heart Transplant Patients at Stanford University Medical Center. Clin Infect Dis. 2001;33(5):629–40.Google Scholar
Hermanns, B, Brunn, A, Schwarz, ER, Sachweh, JS, Seipelt, I, Schroder, JM, et al. Fulminant Toxoplasmosis in a Heart Transplant Recipient. Pathol Res Pract. 2001;197(3):211–5.Google Scholar
Golino, A, Duncan, JM, Zeluff, B, DePriest, J, McAllister, HA, Radovancevic, B, et al. Leishmaniasis in a Heart Transplant Patient. J Heart Lung Transplant. 1992;11(4 Pt 1):820–3.Google Scholar
Fiorelli, AI, Santos, RH, Oliveira, JL Jr., Lourenco-Filho, DD, Dias, RR, Oliveira, AS, et al. Heart Transplantation in 107 Cases of Chagas’ Disease. Transplant Proc. 2011;43(1):220–4.Google Scholar
Deen, JL, Blumberg, DA. Infectious Disease Considerations in Pediatric Organ Transplantation. Semin Pediatr Surg. 1993;2(4):218–34.Google Scholar
Braunlin, EA, Canter, CE, Olivari, MT, Ring, WS, Spray, TL, Bolman, RM, 3rd. Rejection and Infection after Pediatric Cardiac Transplantation. Ann Thorac Surg. 1990;49(3):385–90.Google Scholar
Cladellas, M, Abadal, ML, Ballester, M, Obrador, D, Crexells, C, Matias-Guiu, X, et al. Endomyocardial Diagnosis of Cardiac Lipomatosis. Catheterization and Cardiovascular Diagnosis. 1987;13(4):269–70.Google Scholar
Bonacina, E, Recalcati, F, Mangiavacchi, M, Gronda, E. Interstitial Myocardial Lipomatosis: A Morphological Study on Endomyocardial Biopsies and Diseased Hearts Surgically Removed for Heart Transplantation. Eur Heart J. 1989;10 Suppl D:100–2.Google Scholar
Gao, SZ, Chaparro, SV, Perlroth, M, Montoya, JG, Miller, JL, DiMiceli, S, et al. Post-transplantation Lymphoproliferative Disease in Heart and Heart-Lung Transplant Recipients: 30-year Experience at Stanford University. J Heart Lung Transplant. 2003;22(5):505–14.Google Scholar
Eisen, HJ, Hicks, D, Kant, JA, Montone, KT, Mull, R, Pigott, J, et al. Diagnosis of Posttransplantation Lymphoproliferative Disorder by Endomyocardial Biopsy in a Cardiac Allograft Recipient. J Heart Lung Transplant. 1994;13(2):241–5.Google Scholar
Hanasono, MM, Kamel, OW, Chang, PP, Rizeq, MN, Billingham, ME, van de Rijn, M. Detection of Epstein-Barr Virus in Cardiac Biopsies of Heart Transplant Patients with Lymphoproliferative Disorders. Transplantation. 1995;60(5):471–3.Google Scholar
Schwend, M, Tiemann, M, Kreipe, HH, Parwaresch, MR, Kraatz, EG, Herrmann, G, et al. Rapidly Growing Epstein-Barr Virus-associated Pulmonary Lymphoma after Heart Transplantation. Eur Respir J. 1994;7(3):612–6.Google Scholar
Montone, KT, Friedman, H, Hodinka, RL, Hicks, DG, Kant, JA, Tomaszewski, JE. In Situ Hybridization for Epstein-Barr Virus NotI Repeats in Posttransplant Lymphoproliferative Disorder. Mod Pathol. 1992;5(3):292302.Google Scholar
Lager, DJ, Burgart, LJ, Slagel, DD. Epstein-Barr Virus Detection in Sequential Biopsies from Patients with a Posttransplant Lymphoproliferative Disorder. Mod Pathol. 1993;6(1):42–7.Google Scholar
Ohta, H, Fukushima, N, Ozono, K. Pediatric Post-transplant Lymphoproliferative Disorder after Cardiac Transplantation. Int J Hematol. 2009;90(2):127–36.Google Scholar
Hanto, DW, Birkenbach, M, Frizzera, G, Gajl-Peczalska, KJ, Simmons, RL, Schubach, WH. Confirmation of the Heterogeneity of Posttransplant Epstein-Barr Virus-Associated B Cell Proliferations by Immunoglobulin Gene Rearrangement Analyses. Transplantation. 1989;47(3):458–64.Google Scholar
Kemnitz, J, Cremer, J, Gebel, M, Uysal, A, Haverich, A, Georgii, A. T-cell Lymphoma after Heart Transplantation. Am J Clin Pathol. 1990;94(1):95101.Google Scholar
Chucrallah, AE, Crow, MK, Rice, LE, Rajagopalan, S, Hudnall, SD. Multiple Myeloma after Cardiac Transplantation: An Unusual Form of Posttransplant Lymphoproliferative Disorder. Hum Pathol. 1994;25(5):541–5.Google Scholar
Fishbein, MC, Kobashigawa, J. Biopsy-negative Cardiac Transplant Rejection: Etiology, Diagnosis, and Therapy. Curr Opin Cardiol. 2004;19(2):166–9.Google Scholar
Tan, CD, Sokos, GG, Pidwell, DJ, Smedira, NG, Gonzalez-Stawinski, GV, Taylor, DO, et al. Correlation of Donor-specific Antibodies, Complement and Its Regulators with Graft Dysfunction in Cardiac Antibody-mediated Rejection. Am J Transplant. 2009;9(9):2075–84.Google Scholar
Cohnert, TR, Kemnitz, J, Haverich, A, Dralle, H. Myocardial Calcification after Orthotopic Heart Transplantation. J Heart Transplant. 1988;7(4):304–8.Google Scholar
Florence, SH, Hutton, LC, McKenzie, FN, Kostuk, WJ. Cardiac Transplantation: Postoperative Chest Radiographs. Canadian Association of Radiologists Journal = Journal l’Association canadienne des radiologistes. 1988;39(2):115–7.Google Scholar
Millane, T, Wilson, AJ, Patel, MK, Jennison, SH, Holt, DW, Murday, AJ, et al. Mitochondrial Calcium Deposition in Association with Cyclosporine Therapy and Myocardial Magnesium Depletion: A Serial Histologic Study in Heart Transplant Recipients. J Heart Lung Transplant. 1994;13(3):473–80.Google ScholarPubMed
Yankah, AC, Musci, M, Weng, Y, Loebe, M, Zurbruegg, HR, Siniawski, H, et al. Tricuspid Valve Dysfunction and Surgery after Orthotopic Cardiac Transplantation. Eur J Cardiothorac Surg. 2000;17(4):343–8.Google Scholar
Racusen, LC, Colvin, RB, Solez, K, Mihatsch, MJ, Halloran, PF, Campbell, PM, et al. Antibody-mediated Rejection Criteria – An Addition to the BANFF 97 Classification of Renal Allograft Rejection. Am J Transplant. 2003;3(6):708–14.Google Scholar
Takemoto, SK, Zeevi, A, Feng, S, Colvin, RB, Jordan, S, Kobashigawa, J, et al. National Conference to Assess Antibody-mediated Rejection in Solid Organ Transplantation. Am J Transplant. 2004;4(7):1033–41.Google Scholar
Rodriguez, ER, Skojec, DV, Tan, CD, Zachary, AA, Kasper, EK, Conte, JV, et al. Antibody-mediated Rejection in Human Cardiac Allografts: Evaluation of Immunoglobulins and Complement Activation Products C4d and C3d as Markers. Am J Transplant. 2005;5(11):2778–85.Google Scholar
Tan, CD, Rodriguez, ER. Diagnosis of Antibody-mediated Rejection in Cardiac Transplantation: A Call for Standardization. Current Opinion in Organ Transplantation. 2010.Google Scholar
Hammond, EH, Wittwer, CT, Greenwood, J, Knape, WA, Yowell, RL, Menlove, RL, et al. Relationship of OKT3 Sensitization and Vascular Rejection in Cardiac Transplant Patients Receiving OKT3 Rejection Prophylaxis. Transplantation. 1990;50(5):776–82.Google Scholar
Bishay, ES, Cook, DJ, Starling, RC, Ratliff, NB Jr., White, J, Blackstone, EH, et al. The Clinical Significance of Flow Cytometry Crossmatching in Heart Transplantation. Eur J Cardiothorac Surg. 2000;17(4):362–9.Google Scholar
Michaels, PJ, Espejo, ML, Kobashigawa, J, Alejos, JC, Burch, C, Takemoto, S, et al. Humoral Rejection in Cardiac Transplantation: Risk Factors, Hemodynamic Consequences and Relationship to Transplant Coronary Artery Disease. J Heart Lung Transplant. 2003;22(1):5869.Google Scholar
Taylor, DO, Yowell, RL, Kfoury, AG, Hammond, EH, Renlund, DG. Allograft Coronary Artery Disease: Clinical Correlations with Circulating Anti-HLA Antibodies and the Immunohistopathologic Pattern of Vascular Rejection. J Heart Lung Transplant. 2000;19(6):518–21.Google Scholar
Hammond, ME, Stehlik, J, Snow, G, Renlund, DG, Seaman, J, Dabbas, B, et al. Utility of Histologic Parameters in Screening for Antibody-mediated Rejection of the Cardiac Allograft: A Study of 3,170 Biopsies. J Heart Lung Transplant. 2005;24(12):2015–21.Google Scholar
Bonnaud, EN, Lewis, NP, Masek, MA, Billingham, ME. Reliability and Usefulness of Immunofluorescence in Heart Transplantation. J Heart Lung Transplant. 1995;14(1 Pt 1):163–71.Google Scholar
Kucirka, LM, Maleszewski, JJ, Segev, DL, Halushka, MK. Survey of North American Pathologist Practices Regarding Antibody-mediated Rejection in Cardiac Transplant Biopsies. Cardiovasc Pathol. 2011;20(3):132–8.CrossRefGoogle ScholarPubMed
Revelo, MP, Stehlik, J, Miller, D, Snow, GL, Everitt, MD, Budge, D, et al. Antibody Testing for Cardiac Antibody-mediated Rejection: Which Panel Correlates Best with Cardiovascular Death? J Heart Lung Transplant. 2011;30(2):144–50.CrossRefGoogle ScholarPubMed
Rodriguez, ER, Tan, CD. Pathologic Evaluation for Antibody-mediated Rejection: Prognostic vs Diagnostic Markers? The Journal of Heart and Lung Transplantation: The Official Publication of the International Society for Heart Transplantation. 2011;30(2):136–8.Google Scholar
Baldwin, WM, Ota, H, Rodriguez, ER. Complement in Transplant Rejection: Diagnostic and Mechanistic Considerations. Springer Semin Immunopathol. 2003;25(2):181–97.Google Scholar
Baldwin, WM, 3rd, Kasper, EK, Zachary, AA, Wasowska, BA, Rodriguez, ER. Beyond C4d: Other Complement-related Diagnostic Approaches to Antibody-mediated Rejection. Am J Transplant. 2004;4(3):311–8.Google Scholar
Berry, GJ, Burke, MM, Anderson, C, Bruneval, P, Fedrigo, M, Fishbein, MC, et al. Isht Consensus Statement: International Society for Heart and Lung Transplantation 2013 Working Formulation for the Standardization of Nomenclature in the Pathologic Diagnosis of Antibody-mediated Rejection in Heart Transplantation. J Heart Lung Transplant. 2013;in press.Google Scholar
Miller, DV, Everitt, MD, Molina, KM, Alharethi, R, Budge, D, Wachter, B, et al. Clinical and Prognostic Significance of C3d and C4d Positive Immunopathology Pattern Versus C4d Positive Alone. Journal of Heart and Lung Transplantation. 2013;32(4):S20S.Google Scholar
Rodriguez, R, Moses, JE, Adlington, RM, Baldwin, JE. A New and Efficient Method for O-quinone Methide Intermediate Generation: Application to the Biomimetic Synthesis of the Benzopyran Derived Natural Products (+/-)-Lucidene and (+/-)-Alboatrin. Organic & Biomolecular Chemistry. 2005;3(19):3488–95.Google Scholar
Baldwin, WM, 3rd, Samaniego-Picota, M, Kasper, EK, Clark, AM, Czader, M, Rohde, C, et al. Complement Deposition in Early Cardiac Transplant Biopsies Is Associated with Ischemic Injury and Subsequent Rejection Episodes. Transplantation. 1999;68(6):894900.Google Scholar
Hammond, EH, Yowell, RL, Nunoda, S, Menlove, RL, Renlund, DG, Bristow, MR, et al. Vascular (Humoral) Rejection in Heart Transplantation: Pathologic Observations and Clinical Implications. J Heart Transplant. 1989;8(6):430–43.Google Scholar
Lones, MA, Czer, LS, Trento, A, Harasty, D, Miller, JM, Fishbein, MC. Clinical-pathologic Features of Humoral Rejection in Cardiac Allografts: A Study in 81 Consecutive Patients. J Heart Lung Transplant. 1995;14(1 Pt 1):151–62.Google ScholarPubMed
Loupy, A, Cazes, A, Guillemain, R, Amrein, C, Hedjoudje, A, Tible, M, et al. Very Late Heart Transplant Rejection Is Associated with Microvascular Injury, Complement Deposition and Progression to Cardiac Allograft Vasculopathy. Am J Transplant. 2011;11(7):1478–87.Google Scholar
Mollnes, TE. Complement and Biocompatibility. Vox Sang. 1998;74 Suppl 2:303–7.Google Scholar
Mollnes, TE. Biocompatibility: Complement as Mediator of Tissue Damage and as Indicator of Incompatibility. Experimental and Clinical Immunogenetics. 1997;14(1):24–9.Google Scholar
Williams, JM, Holzknecht, ZE, Plummer, TB, Lin, SS, Brunn, GJ, Platt, JL. Acute Vascular Rejection and Accommodation: Divergent Outcomes of the Humoral Response to Organ Transplantation. Transplantation. 2004;78(10):1471–8.Google Scholar
Haas, M, Rahman, MH, Racusen, LC, Kraus, ES, Bagnasco, SM, Segev, DL, et al. C4d and C3d Staining in Biopsies of ABO- and HLA-incompatible Renal Allografts: Correlation with Histologic Findings. Am J Transplant. 2006;6(8):1829–40.Google Scholar
Kirschfink, M. Targeting Complement in Therapy. Immunol Rev. 2001;180:177–89.Google Scholar
Kim, DD, Song, WC. Membrane Complement Regulatory Proteins. Clinical Immunology (Orlando, Fla). 2006;118(2–3):127–36.Google Scholar
Gonzalez-Stawinski, GV, Tan, CD, Smedira, NG, Starling, RC, Rodriguez, ER. Decay-accelerating Factor Expression May Provide Immunoprotection against Antibody-mediated Cardiac Allograft Rejection. J Heart Lung Transplant. 2008;27(4):357–61.Google Scholar
Wehner, J, Morrell, CN, Reynolds, T, Rodriguez, ER, Baldwin, WM, 3rd. Antibody and Complement in Transplant Vasculopathy. Circ Res. 2007;100(2):191203.CrossRefGoogle ScholarPubMed
Kuo, HH, Morrell, CN, Baldwin, WM, 3rd. Alloantibody Induced Platelet Responses in Transplants: Potent Mediators in Small Packages. Hum Immunol. 2012.CrossRefGoogle Scholar
Labarrere, CA, Woods, JR, Hardin, JW, Campana, GL, Ortiz, MA, Jaeger, BR, et al. Early Prediction of Cardiac Allograft Vasculopathy and Heart Transplant Failure. Am J Transplant. 2011;11(3):528–35.Google Scholar
Libby, P, Pober, JS. Chronic Rejection. Immunity. 2001;14(4):387–97.CrossRefGoogle ScholarPubMed
Tuzcu, EM, Hobbs, RE, Rincon, G, Bott-Silverman, C, De Franco, AC, Robinson, K, et al. Occult and Frequent Transmission of Atherosclerotic Coronary Disease with Cardiac Transplantation. Insights from Intravascular Ultrasound. Circulation. 1995;91(6):1706–13.Google Scholar
Gaudin, PB, Rayburn, BK, Hutchins, GM, Kasper, EK, Baughman, KL, Goodman, SN, et al. Peritransplant Injury to the Myocardium Associated with the Development of Accelerated Arteriosclerosis in Heart Transplant Recipients. Am J Surg Pathol. 1994;18(4):338–46.Google Scholar
Koskinen, P, Lemstrom, K, Bruggeman, C, Lautenschlager, I, Hayry, P. Acute Cytomegalovirus Infection Induces a Subendothelial Inflammation (Endothelialitis) in the Allograft Vascular Wall. A Possible Linkage with Enhanced Allograft Arteriosclerosis. Am J Pathol. 1994;144(1):4150.Google Scholar
Hosenpud, JD, Morris, TE, Shipley, GD, Mauck, KA, Wagner, CR. Cardiac Allograft Vasculopathy. Preferential Regulation of Endothelial Cell-derived Mesenchymal Growth Factors in Response to a Donor-specific Cell-mediated Allogeneic Response. Transplantation. 1996;61(6):939–48.Google Scholar
Petrossian, GA, Nichols, AB, Marboe, CC, Sciacca, R, Rose, EA, Smith, CR, et al. Relation between Survival and Development of Coronary Artery Disease and Anti-HLA Antibodies after Cardiac Transplantation. Circulation. 1989;80(5 Pt 2):III1225.Google Scholar
Smith, SH, Kirklin, JK, Geer, JC, Caulfield, JB, McGiffin, DC. Arteritis in Cardiac Rejection after Transplantation. Am J Cardiol. 1987;59(12):1171–3.Google Scholar
Foerster, A. Vascular Rejection in Cardiac Transplantation. A Morphological Study of 25 Human Cardiac Allografts. APMIS. 1992;100(4):367–76.Google Scholar
Hengstenberg, C, Hufnagel, G, Haverich, A, Olsen, EG, Maisch, B. De Novo Expression of MHC Class I and Class II Antigens on Endomyocardial Biopsies from Patients with Inflammatory Heart Disease and Rejection Following Heart Transplantation. Eur Heart J. 1993;14(6):758–63.Google Scholar
Hosenpud, JD, Everett, JP, Morris, TE, Mauck, KA, Shipley, GD, Wagner, CR. Cardiac Allograft Vasculopathy. Association with Cell-mediated but Not Humoral Alloimmunity to Donor-specific Vascular Endothelium. Circulation. 1995;92(2):205–11.Google Scholar
Duquesnoy, RJ, Kaufman, C, Zerbe, TR, Woan, MC, Zeevi, A. Presence of CD4, CD8 Double-negative and T-cell Receptor-Gamma-Delta-positive T Cells in Lymphocyte Cultures Propagated from Coronary Arteries from Heart Transplant Patients with Graft Coronary Disease. J Heart Lung Transplant. 1992;11(3 Pt 2):S836.Google Scholar
Faulk, WP, Labarrere, CA, Nelson, DR, Pitts, D. Coronary Artery Disease in Cardiac Allografts: Association with Arterial Antithrombin. Transplant Proc. 1995;27(3):1944–6.Google Scholar
Labarrere, CA, Pitts, D, Nelson, DR, Faulk, WP. Coronary Artery Disease in Cardiac Allografts: Association with Depleted Arteriolar Tissue Plasminogen Activator. Transplant Proc. 1995;27(3):1941–3.Google Scholar
Koskinen, PK. The Association of the Induction of Vascular Cell Adhesion Molecule-1 with Cytomegalovirus Antigenemia in Human Heart Allografts. Transplantation. 1993;56(5):1103–8.Google Scholar
Dong, C, Redenbach, D, Wood, S, Battistini, B, Wilson, JE, McManus, BM. The Pathogenesis of Cardiac Allograft Vasculopathy. Curr Opin Cardiol. 1996;11(2):183–90.Google Scholar
Herrington, DM, Nanjee, N, Achuff, SC, Cameron, DE, Dobbs, B, Baughman, KL. Dehydroepiandrosterone and Cardiac Allograft Vasculopathy. J Heart Lung Transplant. 1996;15(1 Pt 1):8893.Google Scholar
Denfield, SW. Cardiac Transplant Coronary Allograft Vasculopathy in Children: Achilles’ Heel. Congenital Heart Disease. 2012;7(4):301.Google Scholar
Jeewa, A, Dreyer, WJ, Kearney, DL, Denfield, SW. The Presentation and Diagnosis of Coronary Allograft Vasculopathy in Pediatric Heart Transplant Recipients. Congenital heart disease. 2012;7(4):302–11.Google Scholar
Billingham, ME. Histopathology of Graft Coronary Disease. J Heart Lung Transplant. 1992;11(3 Pt 2):S3844.Google Scholar
Pucci, AM, Forbes, RD, Billingham, ME. Pathologic Features in Long-term Cardiac Allografts. J Heart Transplant. 1990;9(4):339–45.Google Scholar
Berry, GJ, Rizeq, MN, Weiss, LM, Billingham, ME. Graft Coronary Disease in Pediatric Heart and Combined Heart-Lung Transplant Recipients: A Study of Fifteen Cases. J Heart Lung Transplant. 1993;12(6 Pt 2):S30919.Google Scholar
Clausell, N, Butany, J, Molossi, S, Lonn, E, Gladstone, P, Rabinovitch, M, et al. Abnormalities in Intramyocardial Arteries Detected in Cardiac Transplant Biopsy Specimens and Lack of Correlation with Abnormal Intracoronary Ultrasound or Endothelial Dysfunction in Large Epicardial Coronary Arteries. J Am Coll Cardiol. 1995;26(1):110–9.Google Scholar
Luk, A, Ahn, E, Lee, A, Ross, HJ, Butany, J. Recurrent Cardiac Amyloidosis Following Previous Heart Transplantation. Cardiovasc Pathol. 2010;19(4):e12933.Google Scholar
Caines, AE, Kpodonu, J, Massad, MG, Chaer, R, Evans, A, Lee, JC, et al. Cardiac Transplantation in Patients with Iron Overload Cardiomyopathy. J Heart Lung Transplant. 2005;24(4):486–8.Google Scholar
Kuppahally, SS, Hunt, SA, Valantine, HA, Berry, GJ. Recurrence of Iron Deposition in the Cardiac Allograft in a Patient with Non-HFE Hemochromatosis. J Heart Lung Transplant. 2006;25(1):144–7.Google Scholar
Scott, RL, Ratliff, NB, Starling, RC, Young, JB. Recurrence of Giant Cell Myocarditis in Cardiac Allograft. J Heart Lung Transplant. 2001;20(3):375–80.Google Scholar
Chung, L, Berry, GJ, Chakravarty, EF. Giant Cell Myocarditis: A Rare Cardiovascular Manifestation in a Patient with Systemic Lupus Erythematosus. Lupus. 2005;14(2):166–9.Google Scholar
Kong, G, Madden, B, Spyrou, N, Pomerance, A, Mitchell, A, Yacoub, M. Response of Recurrent Giant Cell Myocarditis in a Transplanted Heart to Intensive Immunosuppression. Eur Heart J. 1991;12(4):554–7.Google Scholar
Strecker, T, Zimmermann, I, Wiest, GH. [Pulmonary and Cardiac Recurrence of Sarcoidosis in a Heart Transplant Recipient]. Dtsch Med Wochenschr. 2007;132(21):1159–62.Google Scholar
Luk, A, Lee, A, Ahn, E, Soor, GS, Ross, HJ, Butany, J. Cardiac Sarcoidosis: Recurrent Disease in a Heart Transplant Patient Following Pulmonary Tuberculosis Infection. Can J Cardiol. 2010;26(7):e2735.Google Scholar
Schwarz, ER, Czer, LS, Simsir, SA, Kass, RM, Trento, A. Amiodarone-induced QT Prolongation in a Newly Transplanted Heart Associated with Recurrent Ventricular Fibrillation. Cardiovascular Journal of Africa. 2010;21(2):109–12.Google Scholar
Miriuka, SG, Langman, LJ, Evrovski, J, Miner, SE, Kozuszko, S, D’Mello, N, et al. Thromboembolism in Heart Transplantation: Role of Prothrombin G20210A and Factor V Leiden. Transplantation. 2005;80(5):590–4.Google Scholar
Mullen, JC, Lemermeyer, G, Bentley, MJ. Recurrent Aortic Dissection after Orthotopic Heart Transplantation. Ann Thorac Surg. 1996;62(6):1830–1.Google Scholar
Hollander, SA, Yasnovsky, JR, Reinhartz, O, Chan, F, Sandborg, C, Hunt, S, et al. Behcet’s Disease and Heart Transplantation: A Word of Caution. J Heart Lung Transplant. 2010;29(11):1306–8.Google Scholar
Akhter, SA, McGinty, J, Konys, JJ, Giesting, RM, Merrill, WH, Wagoner, LE. Recurrent Primary Cardiac Malignant Fibrous Histiocytoma Following Orthotopic Heart Transplantation. J Heart Lung Transplant. 2004;23(12):1447–50.Google Scholar
Myruski, KS, Manecke, GR Jr., Kotzur, A, Wahrenbrock, EA, Jamieson, SW. Late Recurrence of Cardiac Sarcoma Presenting as Giant Pulmonary Artery Aneurysm. J Heart Lung Transplant. 2004;23(12):1445–6.Google Scholar
Bonatti, H, Hoefer, D, Rogatsch, H, Margreiter, R, Larcher, C, Antretter, H. Successful Management of Recurrent Epstein-Barr Virus-associated Multilocular Leiomyosarcoma after Cardiac Transplantation. Transplant Proc. 2005;37(4):1839–44.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the or variations. ‘’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats