Myocardial blush grade (mbg) is not altered by microvasculopathy or acute rejection (ar) occurring early after orthotopic heart transplantation (OHT)
M Zakliczyński, A Lekston, D Konecka-Mrówka, J Nożyński, D Trybunia, Ł Pyka, M Świerad, R Przybylski, M Zembala
Ann Transplant 2009; 14(1): 65-65
Background: A relation between microvasculopathy observed in endomyocardial biopsies (EMBs) and clinical coronary vasculopathy (CAV) after OHT remains controversial. Aim of the study was to find a potential relation between microvasculopathy features and AR observed early after OHT and MBG.
Material/Methods: We performed a retrospective analysis of early coronary
angiographies (performed between 4th and 6th week after OHT) from 55 subjects. Based on MBG analysis we identifi ed a group of six pts. with decreased MBG (6M, 52±7y/o, ischemic c-pathy in 50%), that was confronted with a group of 49 pts. with normal MBG (43M/6F, 45±12y/o, ischemic c-pathy in 39%). Microvasculopathy was assessed using the following features: presence of prominent endothelial cells, degeneration of the endothelium, thickening of the muscle layer, thickening of the vascular wall (basal membrane and muscle layer), presence of lymphocytes in the arteriolar wall with-out any other signs of rejection vasculitis, periarteriolar fibrosis, and an occluded arteriolar lumen.
Results: Significant AR was observed in 17 vs. 10% of pts. with decreased and normal MBG, respectively. All microvasculopathy features, except presence of prominent endothelial cells and periarteriolar fibrosis, were more frequent in pts. with normal MBG. None of the differences was statistically significant.
Conclusions: MBG is not inï¬‚uenced by AR or microvasculopathy features observed early after OHT.
Keywords: Heart Transplantation