Related Experiment Video

Updated: Mar 16, 2026

An Immunological Model for Heterotopic Heart and Cardiac Muscle Cell Transplantation in Rats
09:25

An Immunological Model for Heterotopic Heart and Cardiac Muscle Cell Transplantation in Rats

Published on: May 8, 2020

8.4K

Does asymptomatic recurrent diffuse capillary C4d complement deposition impair cardiac allograft function?

Simone Frea1, Cristina Iacovino2, Michela Botta2

  • 1Division of Cardiology, Internal Medicine Department, Città della Salute e della Scienza and University of Torino, Torino, Italy. simone.frea@libero.it.

Clinical Transplantation
|August 5, 2016
PubMed

Insights

Recurrent antibody-mediated rejection (AMR) in heart transplant patients, even without clear biopsy signs, can lead to adverse graft remodeling and impaired left ventricular function within the first year. Early detection of diffuse capillary C4d immunostaining is crucial.

Area of Science:

  • Cardiology
  • Transplantation Immunology
  • Cardiac Pathology

Background:

  • Antibody-mediated rejection (AMR) is a significant concern after heart transplantation.
  • Asymptomatic recurrent AMR (rAMR), defined by diffuse capillary C4d immunostaining on endomyocardial biopsies (EMBs), requires further investigation for its impact on graft function.
  • Left ventricular (LV) function and remodeling are key indicators of cardiac allograft health.

Purpose of the Study:

  • To evaluate the impact of asymptomatic rAMR on LV function and remodeling in the first year post-heart transplantation.
  • To determine if diffuse capillary C4d immunostaining (rAMR) is an early marker for graft dysfunction.
  • To assess the risk of LV dysfunction and adverse remodeling associated with rAMR.

Main Methods:

  • Prospective study of 54 heart transplant recipients with stable graft function one month post-transplant.
  • Regular echocardiography (490 total) and endomyocardial biopsies (EMBs) were performed during the first year.
  • Asymptomatic rAMR (diffuse capillary C4d immunostaining) was analyzed as a risk factor for graft deterioration.

Main Results:

  • Five patients developed rAMR within the first year.
  • rAMR was significantly associated with increased risk of LV concentric hypertrophy (OR 3.6) and reduced lateral S' peak velocity (OR 2.3).
  • Patients with rAMR exhibited adverse graft remodeling (increased LV end-diastolic volume) and functional deterioration (reduced lateral S' peak velocity).

Conclusions:

  • Recurrent asymptomatic diffuse capillary C4d immunostaining is linked to early adverse cardiac allograft remodeling.
  • rAMR may contribute to the development of graft dysfunction after heart transplantation.
  • Monitoring for C4d deposition is important for identifying early signs of rejection and preserving graft function.
Abstract

Keywords:
C4d complement depositionantibody-mediated cardiac allograft rejectioncardiac allograft vasculopathycardiac remodelingechocardiographyendomyocardial biopsyheart transplantimmunochemistrytissue Doppler imaging

More Related Videos

Author Spotlight: Enhancing Graft Viability Assessment Through Quantitative Metrics and Innovative Reservoir Systems08:49

Author Spotlight: Enhancing Graft Viability Assessment Through Quantitative Metrics and Innovative Reservoir Systems

Published on: August 2, 2024

1.4K
Murine Heterotopic Heart Transplant Technique10:27

Murine Heterotopic Heart Transplant Technique

Published on: July 8, 2014

17.8K

Related Concept Videos

Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
757
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
731
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
716
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
3.4K
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
584