Prognostic Impact of Microvasculopathy on Survival after Heart Transplantation

Introduction

Transplant vasculopathy (TVP) is one of the major lethal complications threatening long-term survival after heart transplantation [1], [2]. Screening for epicardial TVP is established as routine follow-up after heart transplantation, and classification of lesions uses international grading systems [3], [4]. Diagnosis of microvasculopathy in right ventricular biopsies has been described previously [5], [6], [7].

We recently proposed a classification for microvasculopathy that ascertains the prognostic impact of microvasculopathy on graft survival after heart transplantation [8]. Microvasculopathy was defined as stenotic endothelial and/or medial disease and diagnosed by light microscopy (hemalum and eosin [H & E] stainings, ×200, [Fig. 1]) [8]. The proposed grading system is easy to apply in routinely processed endomyocardial biopsies. It supports the prognostic impact of biopsy screening of heart transplant recipients within the first year post-transplant [8].

Fig. 1 Diagnostic schedule of microvasculopathy in posttransplantation biopsies (H & E, ×200) [8]. The endothelial cell layer was defined as the monocell layer at the inner part of the blood vessel wall. The wall layer was defined as the polycell layer close to the endothelium forming the external part of the blood vessel walls.

References

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