Hyperacute rejection in heart allografts. Case studies

Hyperacute rejection in orthotopic heart allografts is a rare event. In our material from a total collective of 524 heart-transplanted patients, we have observed two cases of hyperacute rejection, which are presented in this case report. Histopathologically, this entity is characterized above all by the following triad: pronounced edema, hemorrhages, and regressive changes up to necroses of myocytes. Besides the well-known risk factors, our report draws attention to two further factors possibly associated with an increased risk of hyperacute rejection: 1) repeated cardiac surgery prior to the transplantation, and 2) presence of identical viral genomes in recipient's and donor's heart.