Cellular allograft rejection affecting the donor aorta after combined heart-lung transplantation.
BACKGROUND
Infectious pseudoaneurysms of the ascending aorta are a recognized major complication after heart-lung transplantation.


METHODS
This report describes an unusual and previously unreported complication, that of cellular allograft rejection, which caused a pseudoaneurysm of the donor's ascending aorta in a patient who underwent combined heart-lung transplantation. Repair was performed by primary suture after mobilization of the aortic segments.


RESULTS
On histological examination the resected aneurysm showed evidence of proliferative vasculitis with perivascular infiltration of the vasa vasorum by mononuclear cells. The mononuclear cells were identified as CD4+ and CD8+ by immunohistological staining.


CONCLUSIONS
This report shows that cellular allograft rejection may affect the donor aorta after heart-lung transplantation and may result in pseudoaneurysm formation, even under triple-drug immunosuppression after ABO-compatible allograft transplantation.
Knosalla
C
C
Deutsches Herzzentrum Berlin, Abteilung für Herz-, Thorax- und Gefässchirurgie, Berlin, Germany. knosalla@dhzb.de
Hummel
M
M
Meyer
R
R
Weng
Y G
YG
Hammerschmidt
R
R
Ewert
R
R
Hetzer
R
R
D000328:Adult; D017541:Aneurysm, False / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D001011:Aorta / Q000473:pathology / Q000637:transplantation*; D001014:Aortic Aneurysm / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D001027:Aortography; D006084:Graft Rejection / Q000150:complications* / Q000473:pathology*; D016041:Heart-Lung Transplantation; D006801:Humans; D008297:Male; D014019:Tissue Donors; D014057:Tomography, X-Ray Computed; D014184:Transplantation, Homologous