vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2011-2-70-77vtio-377Research ArticleКлинические наблюденияClinical CasesУСКОРЕННОЕ ГУМОРАЛЬНОЕ ОТТОРЖЕНИЕ АЛЛОТРАНСПЛАНТАТА СЕРДЦАACCELERATED HUMORAL (ANTIBODY-MEDIATED) REJECTION OF THE CARDIAC ALLOGRAFT (A CASE REPORT)КуприяноваА. Г.KupriyanovaA. G.annak2003@bk.ruБелецкаяЛ. В.BeletskayaL. V.ЗайденовВ. А.ZaidenovV. A.ИльинскийИ. М.IljinskyI. M.МожейкоН. П.MogeikoN. P.ТатиевскаяЗ. В.TatievskayaZ. V.ШумаковД. В.ShumakovD. V.ФГУ «Федеральный научный центр трансплантологии и искусственных органов им. академика В.И. Шумакова» Минздравсоцразвития РФ, МоскваРоссияAcademician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, MoscowRussian Federation201116062014132ВЕСТНИК ТРАНСПЛАНТОЛОГИИ И ИСКУССТВЕННЫХ ОРГАНОВ том XIII No 2–20117077Copyright © Куприянова А.Г., Белецкая Л.В., Зайденов В.А., Ильинский И.М., Можейко Н.П., Татиевская З.В., Шумаков Д.В., 20112011Куприянова А.Г., Белецкая Л.В., Зайденов В.А., Ильинский И.М., Можейко Н.П., Татиевская З.В., Шумаков Д.В.Kupriyanova A.G., Beletskaya L.V., Zaidenov V.A., Iljinsky I.M., Mogeiko N.P., Tatievskaya Z.V., Shumakov D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/377

В статье приводится случай ускоренного отторжения аллотрансплантата сердца с подробным описанием морфологических и иммуногистохимических особенностей, выявленных при исследовании эндомиокардиального биоптата и миокарда аллотрансплантата, удаленного при аутопсии. 

In the article there is described the case of the accelerated humoral (antibody-mediated) rejection of the cardiac allograft with morphologic and immunohistochemical details revealed at the investigation of the endomyocardial biopsy and myocardial autopsy. 

аллотрансплантат сердцаускоренное гуморальное отторжениеантитело- обусловленное отторжениеиммунофлюоресценция.cardiac allograftaccelerated humoral rejectionantibody-mediated rejectionimmunofluorescence.ReferencesКуприянова А.Г., Белецкая Л.В., Зайденов В.А. и др. Опыт использования иммуногистохимического метода исследования эндомиокардиальных биопсий в диагностике отторжения гуморального типа у больных с аллотрансплантатом сердца // Вестник транс- плантологии и искусственных органов. 2009. Т. XI. No 3. С. 30–36.Куприянова А.Г., Белецкая Л.В., Зайденов В.А. и др. Опыт использования иммуногистохимического метода исследования эндомиокардиальных биопсий в диагностике отторжения гуморального типа у больных с аллотрансплантатом сердца // Вестник транс- плантологии и искусственных органов. 2009. Т. XI. No 3. С. 30–36.Куприянова А.Г., Белецкая Л.В. Антителоопосредо- ванное (гуморальное) отторжение аллотранспланта- та сердца в клинике // Очерки клинической транс- плантологии / Под редакцией С.В. Готье. М., 2009. С. 285–324.Куприянова А.Г., Белецкая Л.В. Антителоопосредо- ванное (гуморальное) отторжение аллотранспланта- та сердца в клинике // Очерки клинической транс- плантологии / Под редакцией С.В. Готье. М., 2009. С. 285–324.Шумаков В.И., Хубутия М.Ш., Белецкая Л.В. Оттор- жение гуморального типа при аллотрансплантации сердца. Тверь: Триада, 2003. 183 с.Шумаков В.И., Хубутия М.Ш., Белецкая Л.В. Оттор- жение гуморального типа при аллотрансплантации сердца. Тверь: Триада, 2003. 183 с.Bradbery L.E., Kansas G.S., Levy S. et al. The CD19/ CD21 signal transducting complex of human B lympho- cytes includes the target of antiproliferative antibody-1 and Leu-13 molecules // J. Immunol. 1992. Vol. 149. P. 2841–2850.Bradbery L.E., Kansas G.S., Levy S. et al. The CD19/ CD21 signal transducting complex of human B lympho- cytes includes the target of antiproliferative antibody-1 and Leu-13 molecules // J. Immunol. 1992. Vol. 149. P. 2841–2850.Cogert G.A., Subherwal S., Wu G. et al. Incidence of non-cellular (humoral) rejection unchanged in the 1990 decade despite a decrease in cellular rejection // J. Heart Lung Transplant. 2003. Vol. 22. S. 119–142.Cogert G.A., Subherwal S., Wu G. et al. Incidence of non-cellular (humoral) rejection unchanged in the 1990 decade despite a decrease in cellular rejection // J. Heart Lung Transplant. 2003. Vol. 22. S. 119–142.Dempsey P.W., Allison M.E.D., Akkaraju S. et al. C3d of complement as a molecular adjuvant: Bridging in- nate and acquired immunity // Science. 1996. Vol. 271. P. 348–350.Dempsey P.W., Allison M.E.D., Akkaraju S. et al. C3d of complement as a molecular adjuvant: Bridging in- nate and acquired immunity // Science. 1996. Vol. 271. P. 348–350.Dunn M.J., Crisp S.J., Rose M.L. et al. Antiendotheli- al antibodies and coronary artery disease after cardiac transplantation // Lancet. 1992. Vol. 339. P. 1566–1570.Dunn M.J., Crisp S.J., Rose M.L. et al. Antiendotheli- al antibodies and coronary artery disease after cardiac transplantation // Lancet. 1992. Vol. 339. P. 1566–1570.Fishbein M.C., Kobashigawa J. Biopsy-negative cardiac transplant rejection: etiology, diagnosis, and therapy // Curr Opion Cardiol. 2004 Mar. Vol. 19 (2). P. 166–169.Fishbein M.C., Kobashigawa J. Biopsy-negative cardiac transplant rejection: etiology, diagnosis, and therapy // Curr Opion Cardiol. 2004 Mar. Vol. 19 (2). P. 166–169.Hammond E.H., Stehlik J., Snow G. Utility of Histologic Parameters in Screening for Antibody-Mediated Rejec- tion of Cardiac Allograft: A Study of 3170 Biopsies // J. Heart Lung Transplant. 2005. Vol. 24. P. 2015–2021.Hammond E.H., Stehlik J., Snow G. Utility of Histologic Parameters in Screening for Antibody-Mediated Rejec- tion of Cardiac Allograft: A Study of 3170 Biopsies // J. Heart Lung Transplant. 2005. Vol. 24. P. 2015–2021.Ibrahim M., Hendry P., Masters R. et al. Management of acute severe perioperative failure of cardiac allografts: a single-centre experience with a review of the literature // Can. J. Cardiol. 2007, April. Vol. 23 (5). P. 363–367.Ibrahim M., Hendry P., Masters R. et al. Management of acute severe perioperative failure of cardiac allografts: a single-centre experience with a review of the literature // Can. J. Cardiol. 2007, April. Vol. 23 (5). P. 363–367.Lee C-Y., Reynolds M., Garyu G., Baldwin W.M.III. et al. The involvement of FcR mechanisms in antiody-media- ted rejection // Transplantation. 2007. Vol. 84. P. 1324– 1334.Lee C-Y., Reynolds M., Garyu G., Baldwin W.M.III. et al. The involvement of FcR mechanisms in antiody-media- ted rejection // Transplantation. 2007. Vol. 84. P. 1324– 1334.Leech S.H., Rubin S., Eisen H.J. et al. Cardiac transplan- tation across a positive prospective lymphocyte cross- match in sensitized recipients // Clin. Transplant. 2003. Vol. 17 (Suppl. 9). P. 17–26.Leech S.H., Rubin S., Eisen H.J. et al. Cardiac transplan- tation across a positive prospective lymphocyte cross- match in sensitized recipients // Clin. Transplant. 2003. Vol. 17 (Suppl. 9). P. 17–26.Matsumoto A.K., Kopicky-Burd J., Carter R.H. et al. Intersection of the complement and immune sistems: a signal transduction complex of the B lymphocytecontai- ning complement receptor // J. Exp. Med. 1991; Jan 1. Vol. 173 (1). P. 55–64.Matsumoto A.K., Kopicky-Burd J., Carter R.H. et al. Intersection of the complement and immune sistems: a signal transduction complex of the B lymphocytecontai- ning complement receptor // J. Exp. Med. 1991; Jan 1. Vol. 173 (1). P. 55–64.Michaels P.J., Espejo M.L., Kobashigawa J. et al. Hu- moral rejection in cardiac transplantation: risk factors, hemodynamic consequences and relationship to trans- plant coronary artery disease // J. Heart Lung Transplant. 2003; Jan. Vol. 22 (1). P. 58–69.Michaels P.J., Espejo M.L., Kobashigawa J. et al. Hu- moral rejection in cardiac transplantation: risk factors, hemodynamic consequences and relationship to trans- plant coronary artery disease // J. Heart Lung Transplant. 2003; Jan. Vol. 22 (1). P. 58–69.Minami K., Murata K., Lee C-Y. et al. C4d deposition and clearance in cardiac transplants correlates with allo- antibody levels and rejection in rats // Am. J. Transplant. 2006. Vol. 6 (5). P. 923–932.Minami K., Murata K., Lee C-Y. et al. C4d deposition and clearance in cardiac transplants correlates with allo- antibody levels and rejection in rats // Am. J. Transplant. 2006. Vol. 6 (5). P. 923–932.Morgun A., Shulzhenko N., Unterkircher C.S. et al. Pre- and post-transplant anti-myosin and anti-heart shock protein antibodies and cardiac transplantation out- come // J. Heart Lung Transplant. 2004; Feb. Vol. 23 (2). P. 204–209.Morgun A., Shulzhenko N., Unterkircher C.S. et al. Pre- and post-transplant anti-myosin and anti-heart shock protein antibodies and cardiac transplantation out- come // J. Heart Lung Transplant. 2004; Feb. Vol. 23 (2). P. 204–209.Murata K., Baldwin W.M.III. Mechanisms of comple- ment activation, C4d deposition, and their contribu- tion to the pathogenesis of antibody mediated rejec- tion // Transplant Rev (Orlando). 2009 July. Vol. 23 (3). P. 139–150.Murata K., Baldwin W.M.III. Mechanisms of comple- ment activation, C4d deposition, and their contribu- tion to the pathogenesis of antibody mediated rejec- tion // Transplant Rev (Orlando). 2009 July. Vol. 23 (3). P. 139–150.Nath D.S., Basha H.I., Tiriveedhi V. et al. Characteriza- tion of immune responses to cardiac self-antigens myo- sin and vimentin in human cardiac allograft recipients with antibody-mediated rejection and cardiac allograft vasculopathy // J. Heart Lung Transplant. 2010, Nov. Vol. 29 (11). P. 1277–1285.Nath D.S., Basha H.I., Tiriveedhi V. et al. Characteriza- tion of immune responses to cardiac self-antigens myo- sin and vimentin in human cardiac allograft recipients with antibody-mediated rejection and cardiac allograft vasculopathy // J. Heart Lung Transplant. 2010, Nov. Vol. 29 (11). P. 1277–1285.Patel N.D., Weiss E.S., Cameron D.E., Vricella L.A. ABO-incompatible heart transplantation in infants: ana- lysis of the united network for organ sharing databa- se // J. Heart Lung Transplant. 2008, Oct. Vol. 27 (10). P. 1085–1089.Patel N.D., Weiss E.S., Cameron D.E., Vricella L.A. ABO-incompatible heart transplantation in infants: ana- lysis of the united network for organ sharing databa- se // J. Heart Lung Transplant. 2008, Oct. Vol. 27 (10). P. 1085–1089.Tambur A.R., Bray R.A., Takemoto S.K. et al. Flow cyto- metric detection of HLA-specific antibodies as a predic- tor of heart allograft rejection // Transplantation. 2000. Vol. 70. P. 1055–1059.Tambur A.R., Bray R.A., Takemoto S.K. et al. Flow cyto- metric detection of HLA-specific antibodies as a predic- tor of heart allograft rejection // Transplantation. 2000. Vol. 70. P. 1055–1059.Tan C.D., Sokos G.G., Pidwell D.J. et al. Correlation of donor-specific antibodies, complement and its regulators with graft dysfunction in cardiac antibody-mediated re- jection // Am. J. Transplant. 2009. Vol. 9 (9). P. 2075– 2084.Tan C.D., Sokos G.G., Pidwell D.J. et al. Correlation of donor-specific antibodies, complement and its regulators with graft dysfunction in cardiac antibody-mediated re- jection // Am. J. Transplant. 2009. Vol. 9 (9). P. 2075– 2084.Taylor D.O., Yowell R.L., Kfoury A.G. et al. Allograft coronary artery disease: clinical correlations with circu- lating anti-HLA antibodies and the immunohistopatholo- gic pattern of vascular rejection // J. Heart Lung Trans- plant. 2000. Vol. 19. P. 518–521.Taylor D.O., Yowell R.L., Kfoury A.G. et al. Allograft coronary artery disease: clinical correlations with circu- lating anti-HLA antibodies and the immunohistopatholo- gic pattern of vascular rejection // J. Heart Lung Trans- plant. 2000. Vol. 19. P. 518–521.Rodriguez E.R., Skojec D.V., Tan C.D. et al. Antibody- mediated rejection in human cardiac allografts: Evalu- ation of immunoglobulins and complement activation products C4d and C3d as markers // Am. J. Transplant. 2005. Vol. 5. P. 2778–2785.Rodriguez E.R., Skojec D.V., Tan C.D. et al. Antibody- mediated rejection in human cardiac allografts: Evalu- ation of immunoglobulins and complement activation products C4d and C3d as markers // Am. J. Transplant. 2005. Vol. 5. P. 2778–2785.Rose M.L., Cooper D.K., Human P.A. et al. Histopatho- logy of hyperacute rejection of the heart: experimental and clinical observations in allografts and xenografts // J. Heart Lung Transplant. 1991, Mar-Apr. Vol. 10 (2). P. 223–234.Rose M.L., Cooper D.K., Human P.A. et al. Histopatho- logy of hyperacute rejection of the heart: experimental and clinical observations in allografts and xenografts // J. Heart Lung Transplant. 1991, Mar-Apr. Vol. 10 (2). P. 223–234.Warraich R.S., Pomerance A., Stanley A. et al. Cardiac myosin autoantibodies and acute rejection after heart transplantation in patients with dilated cardiomyopa- thy // Transplantation. 2000. Vol. 69. P. 1609–1617.Warraich R.S., Pomerance A., Stanley A. et al. Cardiac myosin autoantibodies and acute rejection after heart transplantation in patients with dilated cardiomyopa- thy // Transplantation. 2000. Vol. 69. P. 1609–1617.Wehner J.R., Morrell C.N., Rodriguez E.R. et al. Immu- nological Challenges of Cardiac Transplantation: the need for better animal models to answer current clinical questions // J. Clin. Immunol. 2009, Nov. Vol. 29 (6). P. 722–729.Wehner J.R., Morrell C.N., Rodriguez E.R. et al. Immu- nological Challenges of Cardiac Transplantation: the need for better animal models to answer current clinical questions // J. Clin. Immunol. 2009, Nov. Vol. 29 (6). P. 722–729.

The authors declare that there are no conflicts of interest present.