Pathologic diagnosis of antibody-mediated rejection in endomyocardial biopsy after heart transplantation based on renewed International Society for Heart and Lung Transplantation criteria.
Heart transplantation is a well-established life-saving treatment for patients presenting with end-stage cardiac failure. Despite improved efficacy of the procedure, allograft rejection continues to be a major cause of mortality and morbidity in cardiact allograft patients. Although acute cellular rejection (ACR) is quite unusual nowadays, acute antibody-mediated rejection (AMR) remains a significant problem. The role of pathologists in detection of AMR is very important, especially in sub-clinical cases. In 1990, histologic hallmarks of AMR were first stated by International Society for Heart and Lung Transplantation (ISHLT) and detailed histopathologic features and immunopathologic criteria were established in 2005. Recently (2013) ISHLT revised nomenclature and classification of AMR. Aim of this paper was to present practical changes coming from new criteria as well as to highlight difficulties concerning AMR assessment in endomyocardial biopsies (EMB).
Sylwia Szymańska, Department of Pathology, The Children's Memorial Health Institute, 04-730 Warsaw, Poland, tel. +48 22 815 19 60, fax +48 22 815 19 75, e-mail: s.szymanska@czd.pl.
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Szymańska
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Grajkowska
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Pronicki
D000906:Antibodies / Q000276:immunology*; D001706:Biopsy; D006084:Graft Rejection / Q000175:diagnosis* / Q000276:immunology; D016027:Heart Transplantation; D006801:Humans; D010340:Pathology, Surgical / Q000379:methods*
D000906:Antibodies