Journal de médecine pulmonaire

Clinical Relevance of Vasculitis in Mild form of Rejections in Heart Transplant patients

M. Fedrigo1 , D. Bottigliengo2 , A. Romano1 , E. Gugole1 , T. Bocca1 , G. Lorenzoni2 , GM. Vescovo1 , I.Barison1 C. Castellani, T. Bottio1 , G. Tarantini1 , G. Toscano1 , A. Nocco3 , 2 , E. Benazzi3 , 2 , C. Castellani1 , G. De Silvestro4 , C.Basso1 , C. Basso, G. Gerosa1 , F. Tona1 , D. Gregori2 and A. Angelini1

Background: Vasculitis had been considered a histopathological marker in severe form of both cellular and humoral rejection. However, in mild forms of rejections, it has not been considered a diagnostic and prognostic histopathologic criterion. Aim of this study is to assess clinical relevance of vasculitis, in terms of mortality and cardiac allograft vasculopathy development, in the mild forms of rejection in heart transplanted patients. Method: We reviewed 2794 monitoring endomyocardial biopsies from 170 adult heart transplanted pts at our center. On endomyocardial biopsies, we evaluated the presence of vasculitis in the different types of rejection. Clinical data were collected during follow up. A Multi-State Markov model was applied to describe the rejection dynamic profile and hazard for mortality, persistence of rejection and CAV development.