Reversible encephalopathy after cardiac transplantation: histologic evidence of endothelial activation, T-cell

C Horbinski1, W S Bartynski, E Carson-Walter

  • 1Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Reversible encephalopathy after transplantation is well recognized. The condition is commonly thought to be related to immune suppression, and a characteristic brain imaging pattern is typically recognized with vasogenic edema in the parietal and occipital regions, typically termed posterior reversible encephalopathy syndrome (PRES). We report the case of a patient with reversible encephalopathy after cardiac transplantation with brain biopsy evidence of endothelial activation, selective intravascular/perivascular T-cell trafficking, and VEGF expression in astrocytes, neurons, and the endothelium.