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Updated: Jul 13, 2026
10:32
Murine Cervical Heart Transplantation Model Using a Modified Cuff Technique
Published on: October 12, 2014
Update on cardiac transplantation pathology.
Carmela D Tan1, William M Baldwin, E Rene Rodriguez
1Department of Anatomic Pathology, The Cleveland Clinic, Cleveland, OH 44195, USA.
Archives of Pathology & Laboratory Medicine
|August 9, 2007
Summary
The revised 2004 grading system for heart transplant biopsies improves assessment of cellular and antibody-mediated rejection. This review details the updated International Society for Heart and Lung Transplantation guidelines for accurate diagnosis and patient care.
Area of Science:
- Cardiovascular Pathology
- Transplant Immunology
- Surgical Pathology
Background:
- Endomyocardial biopsy is crucial for monitoring heart transplant rejection.
- Accurate assessment of rejection types guides immunosuppressive therapy and improves outcomes.
- The 1990 grading system was revised in 2004 to enhance diagnostic accuracy.
Purpose of the Study:
- To provide a practical approach to evaluating human heart transplant biopsies.
- To discuss the revised International Society for Heart and Lung Transplantation (ISHLT) working formulation.
- To detail the evolution of rejection grading and diagnostic criteria.
Main Methods:
- Review of pertinent literature.
- Incorporation of expert insights from ISHLT working groups.
- Analysis of the 1990 and 2004 ISHLT grading systems.
Main Results:
- Presentation of the revised grading system for cellular rejection with detailed morphology.
- Comparison of 1990 and 2004 ISHLT formulations.
- Emphasis on immunostains (C4d, C3d) for antibody-mediated rejection diagnosis.
Conclusions:
- Pathologic recognition of cellular and antibody-mediated rejection has evolved.
- Immunostains for complement components are key in diagnosing antibody-mediated rejection.
- Discussion of pitfalls, artifacts, and cardiac allograft vasculopathy in biopsies.
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