[en] We report the case of a patient with giant cell myocarditis who was bridged to transplantation with mechanical circulatory support and developed a fatal perioperative hyperacute rejection. The patient had received abundant transfusions that had raised her anti-HLA antibody titers. The cross-match test was positive. No pre-transplantation immunosuppressive therapy had been administered given concomitant infection. The severity and acuteness of the rejection in this case likely reflect the combined effect of preformed anti-HLA antibodies in the context of an active organ-specific immune process at the time of transplantation. This case raises the questions of the need for intensive immunosuppressive therapy before transplantation in giant cell myocarditis and of the management of patients with positive cross-match in the context of a giant cell myocarditis.
Delbecque, Katty ; Centre Hospitalier Universitaire de Liège - CHU > Anatomie pathologique
Defraigne, Jean-Olivier ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgie cardio-vasculaire et thoracique
Bouillenne, Claire
Damas, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Soins intensifs
Pierard, Luc ; Centre Hospitalier Universitaire de Liège - CHU > Cardiologie
Boniver, Jacques ; Centre Hospitalier Universitaire de Liège - CHU > Anatomie pathologique
de Leval, Laurence ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Anatomie et cytologie pathologiques - Département des sciences biomédicales et précliniques
Language :
English
Title :
Hyperacute graft rejection during heart transplantation for giant cell myocarditis: A case report.
Publication date :
2010
Journal title :
Pathology - Research and Practice
ISSN :
0344-0338
eISSN :
1618-0631
Publisher :
Gustav Fischer Verlag, Stuttgart, Germany
Volume :
15
Issue :
206
Pages :
411-4
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2009 Elsevier GmbH. All rights reserved.
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