Albat B, Missov E, Serre I, Baldet P, Chaptal P A
Centre Hospitalier Universitaire, Montpellier, France.
Minerva Cardioangiol. 1995 Oct;43(10):435-8.
Transplant-related coronary artery disease is the main cause of death in orthotopic heart transplant recipients one year or more after operation. We report our own experience with chronic vascular rejection occurring 4, 10, and 15 months after transplantation in 3 of 71 consecutive patients. Immunosuppressive regimen included perioperative lymphocyte antibody therapy, cyclosporine, azathioprine and methylprednisolone. All 3 patients received cardiac allografts from donors not the same ABO blood type and developed cytomegalovirus infection (one primary phase infection and two reactivations). Death occurred in all of them. Histologic signs of both cellular and vascular rejection were found in one patient and two had pure vascular rejection. These observations support the potential role of cytomegalovirus infection and donor-recipient partial ABO blood type group incompatibility in the development of allograft vasculopathy as a short-term complication in heart transplant recipients.
移植相关的冠状动脉疾病是原位心脏移植受者术后一年或更长时间死亡的主要原因。我们报告了71例连续患者中3例在移植后4、10和15个月发生慢性血管排斥反应的自身经验。免疫抑制方案包括围手术期淋巴细胞抗体治疗、环孢素、硫唑嘌呤和甲泼尼龙。所有3例患者均接受了来自不同ABO血型供体的心脏移植，并发生了巨细胞病毒感染（1例原发性感染和2例再激活）。他们全部死亡。1例患者发现了细胞和血管排斥反应的组织学征象，另外2例为单纯血管排斥反应。这些观察结果支持了巨细胞病毒感染和供受体部分ABO血型不相容在心脏移植受者短期并发症同种异体移植血管病变发展中的潜在作用。
