The Natural History of Biopsy-Negative Rejection after Heart Transplantation

Joint Authors

Tang, Zhaoyi
Rafiei, Matthew
Stern, Lily Kagan
Kobashigawa, Jon
Hamilton, Michele

Source

Journal of Transplantation

Issue

Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-6, 6 p.

Publisher

Hindawi Publishing Corporation

Publication Date

2013-12-18

Country of Publication

Egypt

No. of Pages

6

Main Subjects

Medicine

Abstract EN

Purpose.

The most recent International Society for Heart and Lung Transplantation (ISHLT) biopsy scale classifies cellular and antibody-mediated rejections.

However, there are cases with acute decline in left ventricular ejection fraction (LVEF ≤ 45%) but no evidence of rejection on biopsy.

Characteristics and treatment response of this biopsy negative rejection (BNR) have yet to be elucidated.

Methods.

Between 2002 and 2012, we found 12 cases of BNR in 11 heart transplant patients as previously defined.

One of the 11 patients was treated a second time for BNR.

Characteristics and response to treatment were noted.

Results.

12 cases (of 11 patients) were reviewed and 11 occurred during the first year after transplant.

8 cases without heart failure symptoms were treated with an oral corticosteroids bolus and taper or intravenous immunoglobulin.

Four cases with heart failure symptoms were treated with thymoglobulin, intravenous immunoglobulin, and intravenous methylprednisolone followed by an oral corticosteroids bolus and taper.

Overall, 7 cases resulted in return to normal left ventricular function within a mean of 14 ± 10 days from the initial biopsy.

Conclusion.

BNR includes cardiac dysfunction and can be a severe form of rejection.

Characteristics of these cases of rejection are described with most cases responding to appropriate therapy.

American Psychological Association (APA)

Tang, Zhaoyi& Kobashigawa, Jon& Rafiei, Matthew& Stern, Lily Kagan& Hamilton, Michele. 2013. The Natural History of Biopsy-Negative Rejection after Heart Transplantation. Journal of Transplantation،Vol. 2013, no. 2013, pp.1-6.
https://search.emarefa.net/detail/BIM-456181

Modern Language Association (MLA)

Tang, Zhaoyi…[et al.]. The Natural History of Biopsy-Negative Rejection after Heart Transplantation. Journal of Transplantation No. 2013 (2013), pp.1-6.
https://search.emarefa.net/detail/BIM-456181

American Medical Association (AMA)

Tang, Zhaoyi& Kobashigawa, Jon& Rafiei, Matthew& Stern, Lily Kagan& Hamilton, Michele. The Natural History of Biopsy-Negative Rejection after Heart Transplantation. Journal of Transplantation. 2013. Vol. 2013, no. 2013, pp.1-6.
https://search.emarefa.net/detail/BIM-456181

Data Type

Journal Articles

Language

English

Notes

Includes bibliographical references

Record ID

BIM-456181