Abstract
We report the case of a 68-year-old woman who underwent heart transplantation for hypertrophic cardiomyopathy. Two months after the transplant she developed mild fever and dyspnea with a marked drop in left ventricle ejection fraction of 31%. Coronary angiography was negative for cardiac allograft vasculopathy. Endomyocardial biopsy revealed ischemic damage with no evidence of acute cellular rejection, antibody-mediated rejection or viral myocarditis. A neoplastic process was suspected even though full-body computerized tomography was negative for malignancy. The patient died 4 months after transplantation. The autopsy showed acute antero-septal myocardial infarction due to a nodular epicardial EBV-related posttransplant lymphoproliferative disorder (PTLD) infiltrating the left anterior descending coronary artery with occlusive neoplastic thrombosis. We highlight two major aspects of this case: (1) the unusual occurrence of early PTLD involving the cardiac allograft and causing a fatal outcome, (2) the application of an immunological technique for HLA-DRB1 typing to posttransplant paraffin-embedded autopsy material to identify the recipient origin of this early malignancy, thus excluding a possible donor-transmitted neoplasm. The authors report the application of HLA typing technique to identify neoplastic donor/recipient cell origin from a tumor mass infiltrating the coronary artery of a heart allograft.
Original language | English |
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Pages (from-to) | 802-807 |
Number of pages | 6 |
Journal | American Journal of Transplantation |
Volume | 13 |
Issue number | 3 |
DOIs | |
Publication status | Published - Mar 2013 |
Keywords
- Heart transplant
- HLA-typing
- PTLD
ASJC Scopus subject areas
- Transplantation
- Immunology and Allergy
- Pharmacology (medical)