Human cardiac transplantation--evaluation of morphological changes in serial endomyocardial biopsies

From May 1981 through July 1984 a total of 29 human allogenic orthotopic cardiac transplants were performed in Munich. The first two patients initially received conventional immunosuppressive treatment for 79 and 27 days, respectively; then treatment was continued with cyclosporine. All subsequent 27 patients received only cyclosporine treatment. Seventeen of the cardiac recipients are currently alive. Three of the recipients who died succumbed to immunological rejection. Twenty-five cardiac grafts were controlled by 355 sequential biopsy procedures, which yielded 1158 endomyocardial specimens for histological examination. The morphological findings and changes observed in the endomyocardium were analyzed. The interpretation of these findings and difficulties encountered in their interpretation are discussed. Special attention is attributed to findings possibly associated with the cyclosporine treatment.