October 1, 2011

Very late heart transplant rejection is associated with microvascular injury, complement deposition and progression to cardiac allograft vasculopathy

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There is ongoing debate as to the clinical importance of late rejection following heart transplantation detected on routine biopsy.  More and more programs have moved away from routine biopsies beyond 3-5 years post-transplant, negating the possibility of even detecting this late rejection.  In this provocative study, the authors assess both the pathologic charactistics, presence of donor-specific antibodies and outcomes in a cohort of patients beyond seven years post-transplant.  Despite no difference between study groups, the changes identified in the late rejectors suggested an antibody-mediated process and were associated with progression to severe coronary artery vasculopathy in follow up.

Cardiac Transplantation

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