TRANSPLANTED HEART. RIGHT VENTRICULAR FAILURE, REJECTION OR MYOCARDITIS?
https://doi.org/10.15825/1995-1191-2011-1-65-71
Abstract
The differentiation of the cases of the right ventricular failure in transplanted heart should be complex and challenging. The 28-year old man with dilated cardiomyopathy underwent orthotopic heart transplantation. After transplantation developed right ventricular failure. The biopsy (n = 5) didn’t reveal any signs of myocardial rejection. There were noted some signs of inflammation in lateral right ventricular wall only by gated SPECT. The right ventricular failure increased and 6 months later there was successfully performed the heart retransplantation on the patient. The virusological study revealed the Epstein–Barr virus in myocardium. The explanted heart research excluded limphoproliferative disease by immunogystochemical tests. The final diagnosis is myocarditis.
About the Authors
E. N. Ostroumov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
E. D. Kotina
Saint-Petersburg State University, Saint-Petersburg
Russian Federation
Russian Federation
R. Sh. Saitgareev
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
D. V. Shumakov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
E. N. Kazakov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
V. N. Poptsov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
T. M. Polotskaya
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
A. Y. Kormer
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
V. M. Zakharevich
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
I. M. Ilinsky
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
N. P. Mojeiko
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
E. I. Ryaboshtanova
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
L. V. Beletskaya
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
A. G. Kupriyanova
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
R. Y. Voilokova
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
T. V. Pestretsova
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
S. V. Mironov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
A. E. Ermolenko
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
References
1. Hosenpud J.D., Bennett L.E., Keck B.M. et al. The Re- gistry of the International Society for Heart and Lung Transplantation: seventeenth official report-2000 // J. Heart. Lung Transplant. 2000. Vol. 19. P. 909–931.
2. Stobierska-Dzierzek B., Awad H., Michler R.E. The evol- ving management of acute right-sided heart failure in cardiac transplant recipients // J. Am. Coll Cardiol. 2001. Vol. 38. P. 923–931.
3. Taylor D.O., Edwards L.B., Boucek M.M. et al. Registry of the International Society for Heart and Lung Trans- plantation: twenty-fourth official adult heart transplant report-2007 // J. Heart Lung Transplant. 2007. Vol. 26. P. 769–814.
4. Paya C.V., Fung J.J., Nalesnik M.A. et al. Epstein-Barr virus-Iinduced posttransplantant lymphoproliferati- ve disorders // Transplantation. 1999. Vol. 68. No 10. P. 1517–1525.
5. Hirokawa M., Kawabata Y., Fujishima N. et al. Late-on- set post-transplant lymphoproliferative disease presen- ting as massive occult gastrointestinal haemorrhage // Singapore Med. J. 2008. Vol. 49. No 5. P. e117–e120
6. Reitman M.J., Zirin H.J., DeAngelis C.J. Complete Heart Block in Epstein-Barr Myocarditis // Pediatrics. 1978. Vol. 62. No 5. P. 847–849.
7. Takano H., Nakagawa K., Ishio N. et al. Active myocardi- tis in a patient with chronic active Epstein-Barr virus infec- tion // Int. J. Cardiol. 2008. Vol. 130. ISSN: P. 1874–1754.
8. Ishikawa T., Zhu B-Li, Li D-Ri et al. Epstein-Barr virus myocarditis as a cause of sudden death: two autopsy ca- ses // Int. J. Legal Med. 2005. Vol. 119. P. 231–235.
9. McFalls E.O., van Suylen R.J. Myocarditis as a cause of primary right ventricular failure. Chest. 1993. Vol. 103. P. 1607–1608.
10. Baughman K.L. Diagnosis of Myocarditis – Death of Dallas Criteria. Circulation. 2006. Vol. 113. P. 593–595.
11. Fishbein M.C., Kobashigawa J. Biopsy-negative cardiac transplant rejection: etiology, diagnosis, and therapy. Current Opinion in Cardiology. 2004. Vol. 19. P. 166–169.
12. Остроумов Е.Н., Захаревич В.М., Котина Е.Д. и др. Результаты томосцинтиграфии миокарда, синхрони- зированной с ЭКГ, у больных с биопсия-негативным отторжением пересаженного сердца // Вестник трансплантологии и искусственных органов. 2009. No 3. C. 62–68.
13. Baumgartner W.A. Heart and Lung Transplantation. 2002.
14. Kirklin J.K., Young J.B., McGiffin D.C. Heart Transplantation. 2002.
15. Cooper D.K.C., Miller L.W., Patterson G.A. The transplantation and replacement of thoracic organs. 1996.
Review
For citations:
Ostroumov E.N., Kotina E.D., Saitgareev R.Sh., Shumakov D.V., Kazakov E.N., Poptsov V.N., Polotskaya T.M., Kormer A.Y., Zakharevich V.M., Ilinsky I.M., Mojeiko N.P., Ryaboshtanova E.I., Beletskaya L.V., Kupriyanova A.G., Voilokova R.Y., Pestretsova T.V., Mironov S.V., Ermolenko A.E. TRANSPLANTED HEART. RIGHT VENTRICULAR FAILURE, REJECTION OR MYOCARDITIS? Russian Journal of Transplantology and Artificial Organs. 2011;13(1):65-71. (In Russ.) https://doi.org/10.15825/1995-1191-2011-1-65-71
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