HLA-DRB1 typing by micro-bead array assay identifies the origin of early lymphoproliferative disorder in a heart transplant recipient

M. Fedrigo, F. Poli, G. Esposito, G. Feltrin, G. Toscano, C. D'Agostino, B. Schiavon, G. Gerosa, A. Amadori, M. Valente, G. Thiene, A. Angelini

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Pages (from-to)802-807
Number of pages6
JournalAmerican Journal of Transplantation
Volume13
Issue number3
DOIs
Publication statusPublished - Mar 2013

Keywords

  • Heart transplant
  • HLA-typing
  • PTLD

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Fingerprint Dive into the research topics of 'HLA-DRB1 typing by micro-bead array assay identifies the origin of early lymphoproliferative disorder in a heart transplant recipient'. Together they form a unique fingerprint.

Cite this