Bhalodolia Rajeshkumar, Cortese Cherise, Graham Michael, Hauptman Paul J
Department of Medicine, Saint Louis University School of Medicine, St. Louis, Missouri 63110, USA.
J Heart Lung Transplant. 2006 Aug;25(8):989-92. doi: 10.1016/j.healun.2006.04.002. Epub 2006 Jun 30.
We present a case of a heart transplant recipient who had new-onset heart failure, repeatedly unremarkable endomyocardial biopsies, a negative evaluation for humoral rejection, and subsequently autopsy findings of severe sub-epicardial myocyte necrosis with classic cellular rejection. The sub-endocardial layer was free from rejection. The implications for clinical management, in the context of a diagnosis of "biopsy-negative rejection with hemodynamic compromise," include the need to consider intensification of immunosuppression with regimens similar to those used for biopsy-proven rejection.
我们报告了一例心脏移植受者的病例，该患者出现新发心力衰竭，多次心内膜心肌活检结果均无异常，体液排斥反应评估为阴性，随后尸检发现严重的心外膜下心肌细胞坏死伴典型的细胞排斥反应。心内膜下层无排斥反应。对于诊断为“活检阴性但有血流动力学损害的排斥反应”的临床管理而言，其意义包括需要考虑采用与活检证实的排斥反应所用方案类似的免疫抑制强化方案。
