1. Inflammatory cell burden and phenotype in endomyocardial biopsies with antibody-mediated rejection (AMR): a multicenter pilot study from the AECVP.
- Author
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Fedrigo M, Leone O, Burke MM, Rice A, Toquet C, Vernerey D, Frigo AC, Guillemain R, Pattier S, Smith J, Lota A, Potena L, Bontadini A, Ceccarelli C, Poli F, Feltrin G, Gerosa G, Manzan E, Thiene G, Bruneval P, Angelini A, and Duong Van Huyen JP
- Subjects
- Adult, Biopsy, Capillaries metabolism, Capillaries pathology, Case-Control Studies, Complement C4b metabolism, Europe, Female, Graft Rejection epidemiology, Humans, Incidence, Male, Middle Aged, Peptide Fragments metabolism, Pilot Projects, Retrospective Studies, Tissue Donors, Antibodies immunology, Graft Rejection immunology, Graft Rejection pathology, Heart Transplantation, Inflammation pathology, Myocarditis pathology, Phenotype
- Abstract
This multicenter case-controlled pilot study evaluated myocardial inflammatory burden (IB) and phenotype in endomyocardial biopsies (EMBs) with and without pathologic antibody-mediated rejection (pAMR). Sixty-five EMBs from five European heart transplant centers were centrally reviewed as positive (grade 2, n = 28), suspicious (grade 1, n = 7) or negative (n = 30) for pAMR. Absolute counts of total, intravascular (IV) and extravascular (EV) immunophenotyped mononuclear cells were correlated with pAMR grade, capillary C4d deposition, donor specific antibody (DSA) status and acute cellular rejection (ACR). In pAMR+ biopsies, equivalent number of IV CD3+ T lymphocytes (23 ± 4/0.225 mm(2) ) and CD68+ macrophages (21 ± 4/0.225 mm(2) ) were seen. IB and cell phenotype correlated with pAMR grade, C4d positivity and DSA positivity (p < 0.0001). High numbers of IV T lymphocytes were associated with low grade ACR (p = 0.002). In late-occurring AMR EV plasma cells occurring in 34% of pAMR+ EMBs were associated with higher IB. The IB in AMR correlated with pAMR+, C4d positivity and DSA positivity. In pAMR+ equivalent numbers of IV T lymphocytes and macrophages were found. The presence of plasma cells was associated with a higher IB and occurrence of pAMR late after transplantation., (© Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Published
- 2015
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