Ultrastructural and Histopathologic Observations of a Human Cardiac Transplant with Features of Rejection

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Abstract
A 43-year-old man who had intractable heart failure due to coronary artery disease underwent heart transplantation. The postoperative period was complicated by gastrointestinal bleeding and pulmonary infection which led to renal shutdown on the eighth postoperative day and to death two weeks after surgery. The transplanted heart was examined by light and electron microscopy. Changes compatible with rejection, including mononuclear infiltration, vascular changes, and foci of myocytolysis and myocardial necrosis, were found. No such changes were seen in the upper parts of the recipient's atria or his aorta. At no time during the postoperative period were clinical or electrocardiographic evidences of rejection observed.

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