Frazier O H, McAllister H A, Jammal C T, Van Buren C T, Okereke O U, Radovancevic B, Cooley D A
Ann Thorac Surg. 1987 May;43(5):554-6. doi: 10.1016/s0003-4975(10)60209-3.
A patient died 5 months after undergoing cardiac transplantation. Endomyocardial biopsies performed prior to death showed no evidence of severe rejection. At autopsy, nonnecrotizing occlusive coronary arteritis was present. The intima of the coronary arteries contained numerous lymphocytes and plasma cells. Chronic rejection appeared to be responsible for the arteritis. The onset of coronary occlusive disease is insidious, and recognition depends on the performance of coronary arteriography, which is usually not done until the one-year follow-up. Early coronary arteriography is suggested to rule out occlusive coronary arteritis when cardiac allograft function is not satisfactory, even when the endomyocardial biopsy shows no evidence of rejection.
一名患者在接受心脏移植术后5个月死亡。死亡前进行的心肌内膜活检未显示严重排斥反应的迹象。尸检时发现有非坏死性闭塞性冠状动脉炎。冠状动脉内膜含有大量淋巴细胞和浆细胞。慢性排斥反应似乎是导致动脉炎的原因。冠状动脉闭塞性疾病的发病隐匿，其诊断依赖于冠状动脉造影检查，而冠状动脉造影通常在术后一年随访时才进行。当心脏移植功能不佳时，即使心肌内膜活检未显示排斥反应迹象，也建议早期进行冠状动脉造影以排除闭塞性冠状动脉炎。
