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The pathological implications of heart transplantation: Experience with 50 cases in a single center
Author(s) -
IshibashiUeda Hatsue,
Ikeda Yoshihiko,
Matsuyama Takaaki,
OhtaOgo Keiko,
Sato Takuma,
Seguchi Osamu,
Yanase Masanobu,
Fujita Tomoyuki,
Kobayashi Junjiro,
Nakatani Takeshi
Publication year - 2014
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/pin.12189
Subject(s) - medicine , transplantation , heart transplantation , sepsis , pathological , cardiomyopathy , surgery , single center , hypertrophic cardiomyopathy , autopsy , cardiology , heart failure , gastroenterology
Heart transplantation started in J apan in 1999. Since then, 50 transplants have been performed at our center. We performed histopathological analyses of the 50 explanted hearts and the post‐transplant biopsy specimens. The median age of recipients was 39 years. The primary diseases before transplant were idiopathic dilated cardiomyopathy in 33 patients (66%), hypertrophic cardiomyopathy in seven (14%), restrictive cardiomyopathy in one, arrhythmogenic right ventricular cardiomyopathy in one, and secondary cardiomyopathy in eight (16%). Before transplantation, 47 patients (94%) had left ventricular assist devices. No severe cardiovascular failure due to allograft rejection occurred. The post‐transplant survival rate was 97.6% at 1 year and 93.1% at 10 years. One recipient was lost to sepsis from myelodysplastic syndrome in the fourth year, one died of multiple organ failure and peritonitis 8 months after transplant. Another patient died of recurrent post‐transplant lymphoproliferative disorders ( PTLD ). Mild cardiac dysfunction occurred in seven recipients in the early postoperative period. Moderate acute cellular rejection occurred in six patients (12%), and antibody‐mediated rejection occurred in three (6%). The number of heart transplants performed in J apan is very small. However, the outstanding 10‐year survival rate is due to donor evaluation and post‐transplant care resulting in low grade rejection. Pathological evaluation has also greatly contributed to the results.