Literature DB >> 8241211

Endocardial infiltrates in the transplanted heart: clinical significance emerging from the analysis of 5026 endomyocardial biopsy specimens.

M R Costanzo-Nordin1, G L Winters, S G Fisher, J O'Sullivan, A L Heroux, W Kao, G M Mullen, M R Johnson.   

Abstract

UNLABELLED: To further elucidate the significance of endocardial infiltrates in heart transplant patients, the presence, frequency, and type of endocardial infiltrates were evaluated in 5026 endomyocardial biopsy specimens obtained from 200 heart transplant patients 0 to 75 months after heart transplantation. The relationship of endocardial infiltrates to immunologic, clinical, and demographic variables was then explored. Endocardial infiltrates were detected in 557 endomyocardial biopsy specimens (11%) from 117 heart transplant patients (58%) at 6.3 +/- 9.4 months (mean +/- SD; range, 0 to 49 months) after heart transplantation. Heart transplant patients with endocardial infiltrates were younger (p = 0.03), had a greater incidence of idiopathic dilated cardiomyopathy before heart transplantation (p = 0.05), and included a greater percentage of females (p < 0.05). Both total and treated rejection rates were significantly higher in patients with endocardial infiltrates versus those without endocardial infiltrates (p = 0.0001). Rejection on the subsequent endomyocardial biopsies was more often present in endocardial biopsy specimens with endocardial infiltrates than in those without endocardial infiltrates, both in the presence (37% versus 24%; p < 0.001) and absence (33% versus 19%; p < 0.0001) of concomitant findings of rejection. No association was identified between endocardial infiltrates and posttransplantation lymphoproliferative disorder, cytomegalovirus infection, Epstein-Barr virus infection, or cardiac allograft vasculopathy. Multivariate regression analysis confirmed that the occurrence of endocardial infiltrates is associated with rejection when adjustment is made for patient's age, gender, heart disease before transplantation, follow-up time, and number of endomyocardial biopsies after heart transplantation (p = 0.0001).
CONCLUSIONS: (1) Endocardial infiltrates may occur with or without associated endomyocardial biopsy findings of rejection.(ABSTRACT TRUNCATED AT 250 WORDS)

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Year:  1993        PMID: 8241211

Source DB:  PubMed          Journal:  J Heart Lung Transplant        ISSN: 1053-2498            Impact factor:   10.247


  4 in total

1.  Adult heart transplantation under tacrolimus (FK506) immunosuppression: histopathologic observations and comparison to a cyclosporine-based regimen with lympholytic (ATG) induction.

Authors:  A C Tsamandas; S M Pham; E C Seaberg; O Pappo; R L Kormos; A Kawai; B P Griffith; A Zeevi; R Duquesnoy; J J Fung; T E Starzl; A J Demetris
Journal:  J Heart Lung Transplant       Date:  1997-07       Impact factor: 10.247

2.  Revision of the 1990 working formulation for cardiac allograft rejection: the Sheffield experience.

Authors:  S K Suvarna; A Kennedy; F Ciulli; T J Locke
Journal:  Heart       Date:  1998-05       Impact factor: 5.994

Review 3.  Chronic rejection. A general overview of histopathology and pathophysiology with emphasis on liver, heart and intestinal allografts.

Authors:  A J Demetris; N Murase; R G Lee; P Randhawa; A Zeevi; S Pham; R Duquesnoy; J J Fung; T E Starzl
Journal:  Ann Transplant       Date:  1997       Impact factor: 1.530

4.  Analysis of chronic rejection and obliterative arteriopathy. Possible contributions of donor antigen-presenting cells and lymphatic disruption.

Authors:  A J Demetris; N Murase; Q Ye; F H Galvao; C Richert; R Saad; S Pham; R J Duquesnoy; A Zeevi; J J Fung; T E Starzl
Journal:  Am J Pathol       Date:  1997-02       Impact factor: 4.307

  4 in total

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