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Pathology of Antibody-Mediated Rejection

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The Pathology of Cardiac Transplantation

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Abstract

Antibody-mediated rejection (AMR) is now recognized as an important clinical complication of pediatric and adult cardiac transplantation. In addition to causing graft dysfunction, it has been associated with the accelerated development of transplant vasculopathy and graft loss. It can occur early after transplantation, especially in presensitized patients, but late-onset antibody-mediated rejection is now encountered more frequently. It is characterized by microvascular injury centered on the myocardial interstitial capillaries. The diagnosis is currently based on histopathologic and immunophenotypic criteria without reference to clinical status or presence of circulating donor-specific antibodies. The current International Society for Heart and Lung Transplantation grading scheme incorporates the constellation of histopathologic and immunopathologic findings and is now widely utilized for the diagnosis and reporting of AMR.

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Author information

Authors and Affiliations

  1. Institute of Pathology, University Hospital of Lausanne, Lausanne-CHUV, Switzerland

    Samuel Rotman

  2. Intermountain Central Lab, University of Utah, Salt Lake City, UT, USA

    Dylan V. Miller

  3. Department of Pathology, Hôpital Hôtel-Dieu, Nantes, France

    Claire Toquet MD, PhD

  4. Department of Pathology, Stanford University, Stanford, CA, USA

    Gerald J. Berry

Authors
  1. Samuel Rotman
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  2. Dylan V. Miller
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  3. Claire Toquet MD, PhD
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  4. Gerald J. Berry
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Corresponding author

Correspondence to Claire Toquet MD, PhD .

Editor information

Editors and Affiliations

  1. Cardiovascular and Cardiac Transplant Pathology Program Department of Pathology, Sant’Orsola-Malpighi University Hospital, Bologna, Italy

    Ornella Leone

  2. Pathology of Cardiac Transplantation and Regenerative Medicine Unit Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy

    Annalisa Angelini

  3. Department of Pathology, Hôpital Européen Georges Pompidou, Paris, France

    Patrick Bruneval

  4. Heart Failure and Heart Transplant Program, Cardiology Unit, Sant’Orsola-Malpighi University Hospital, Bologna, Italy

    Luciano Potena

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© 2016 Springer International Publishing Switzerland

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Rotman, S., Miller, D.V., Toquet, C., Berry, G.J. (2016). Pathology of Antibody-Mediated Rejection. In: Leone, O., Angelini, A., Bruneval, P., Potena, L. (eds) The Pathology of Cardiac Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-46386-5_14

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  • DOI: https://doi.org/10.1007/978-3-319-46386-5_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-46384-1

  • Online ISBN: 978-3-319-46386-5

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