Document Detail

Venular thrombosis is the key event in the pathogenesis of antibody-mediated cardiac rejection.
MedLine Citation:
PMID:  10809055     Owner:  NLM     Status:  MEDLINE    
A review of the histopathologic features of serial biopsies and excised grafts of 117 experimental and clinical cardiac allografts and xenografts revealed a common sequence in the development of histopathologic changes in grafts showing antibody-mediated (hyperacute and acute vascular) rejection. Based on these observations, we propose the new concept that thrombosis of cardiac veins and venules is the initial key event in antibody-mediated rejection. This is followed by the development of congestion in the subtended venules and capillaries accompanied by interfascicular and, later, intermyocyte edema. Subsequently, focal or diffuse interstitial hemorrhage affecting the subendocardium, extending sometimes to involve the inner half of the ventricular myocardium, is observed. Antibody-mediated rejection therefore appears to be analogous to incomplete venous infarction of the heart. The observed histopathology (in which venular thrombosis plays a key role) favors a thrombogenic basis for the classical features of antibody-mediated rejection, namely edema, vascular thrombi and interstitial hemorrhage. A key role for venular thrombosis would explain the non-uniform distribution of the changes and may suggest new ways of preventing antibody-mediated xenograft rejection.
A G Rose; D K Cooper
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Xenotransplantation     Volume:  7     ISSN:  0908-665X     ISO Abbreviation:  Xenotransplantation     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-08-29     Completed Date:  2000-08-29     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  9438793     Medline TA:  Xenotransplantation     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  31-41     Citation Subset:  IM    
Department of Laboratory Medicine and Pathology, University of Minnesota and Fairview-University Medical Center, Minneapolis 55455, USA.
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MeSH Terms
Antibodies, Heterophile / toxicity*
Capillaries / immunology,  pathology
Cell Movement / immunology
Coronary Vessels / immunology,  pathology
Edema / immunology,  pathology
Endocardium / immunology,  pathology
Graft Rejection / etiology,  immunology*,  pathology*
Heart Transplantation / immunology,  pathology
Immunity, Cellular
Isoantibodies / toxicity*
Leukocytes / immunology,  pathology
Transplantation, Heterologous
Transplantation, Homologous
Venous Thrombosis / etiology,  immunology*,  pathology*
Reg. No./Substance:
0/Antibodies, Heterophile; 0/Isoantibodies

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