Pathologic diagnosis of antibody-mediated rejection in endomyocardial biopsy after heart transplantation based on renewed International Society for Heart and Lung Transplantation criteria

Abstract

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).

Circular RNA circSnx5 Controls Immunogenicity of Dendritic Cells through the miR-544/SOCS1 Axis and PU.1 Activity Regulation

“…Hematoxylin and eosin staining was assessed as grades from 0 (none) to 4 (severe), according to the 2014 classification of the International Society for Heart and Lung Transplantation for Acute Cellular Rejection. 61 For EAM mice, heart weight was measured at 21 days after myosin injection, and the hearts were stained with hematoxylin and eosin and assayed according to a semiquantitative scale as described previously: 40 0, no inflammatory infiltrates; 1, small foci of inflammatory cells between myocytes; 2, larger foci of >100 inflammatory cells; 3, involvement of <10% of a cross-section; 4, involvement of >30% of a cross-section.…”

Heart Transplant: Protocol for Monitoring Posttransplant Complications

“…The diagnosis is more difficult to establish, and can rely on endomyocardial biopsy, wherein vessel wall edema, swelling of endothelial cells in the presence or absence of plasma cells infiltrate, can be observed. The late detection of a humoral rejection entrails the risk of chronic rejection installation [15].…”