Abstract
The pathologic basis of acute cardiac transplant rejection is the infiltration of activated lymphocytes into the myocardium.1 With increasing severity of allograft rejection, the perivascular lymphocytic infiltration evolves into multifocal and more diffuse infiltration. The interstitial lymphocytic aggregates are subsequently associated with myocyte damage in higher grades of rejection. The damage is the result of activated lymphocytes attacking the myocytes, and this effect may persistent after the rejection has started to resolve. In severe degrees of rejection, diffuse inflammatory process becomes more aggressive and is associated with vasculitis, interstitial hemorrhage, and edema. Therefore, the acute rejection is graded as IA, IB, II, IIIA, IIIB, and IV based on the pattern and degree of lymphocytic infiltration and the degree of inflammation within the myocardium.1
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Lin, K., Frost, J.J. (2001). Detection of Cardiac Allograft Rejection by Noninvasive Imaging of Lymphocyte Infiltration. In: Dec, G.W., Narula, J., Ballester, M., Carrio, I. (eds) Cardiac Allograft Rejection. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1649-1_18
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DOI: https://doi.org/10.1007/978-1-4615-1649-1_18
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