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Graft Failure/Dysfunction: Clinical Issues and Role of Endomyocardial Biopsy

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The Pathology of Cardiac Transplantation

Abstract

The chapter describes the main clinical scenarios leading to graft failure/dysfunction in heart recipients and provides clinical contextualization for pathologists required to identify the possible main underlying causes.

We summarize clinical definitions and presentations of early/late and acute/chronic graft dysfunction and donor or recipient factors that can influence their development and different aetiologies, which typically vary during the course of post-transplant follow-up.

Because clinical presentation of graft dysfunction is usually not aetiology-specific, we also discuss the role of endomyocardial biopsy (EMB) in defining aetiology, in relation to acute or chronic presentation.

The different role of EMB when performed in scheduled protocols or in presence of a systolic or diastolic graft dysfunction is also thoroughly treated and the spectrum of myocardial inflammation findings to evaluate and interpret in heart transplant patients is described.

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Author information

Authors and Affiliations

  1. Heart Failure and Heart Transplant Program, Cardiology Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy

    Luciano Potena & Valentina Manfredini

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

    Ornella Leone

Authors
  1. Luciano Potena
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  2. Valentina Manfredini
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  3. Ornella Leone
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Corresponding author

Correspondence to Luciano Potena .

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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Potena, L., Manfredini, V., Leone, O. (2016). Graft Failure/Dysfunction: Clinical Issues and Role of Endomyocardial Biopsy. 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_10

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  • DOI: https://doi.org/10.1007/978-3-319-46386-5_10

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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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