MORPHOLOGICAL INDICATORS OF MYOCARDIAL DAMAGES IN REJECTION OF TRANSPLANTED HEART

Abstract

Aim. Characterization of histological indicators of myocardial damage in rejection of transplanted heart using computer morphometry to improve the quality of biopsy diagnostics. Materials and methods. Endomyocardial biopsies of 31 patients after cardiac transplantation were used. Histological sections were stained using the standard procedure with hematoxylin and eosin, and also with picro-fuchsin by van Gieson. The area of the biopsy sample, fibrosis, necrosis, lipomatosis and hemorrhages, as well as the number of cells in the infiltrate, was assessed using computer morphometry. Results. All biopsies are divided according to the degrees of rejection as follows: degree 0R – 16 samples, 1R – 14 samples, 2R – 10 samples, 3R – 4 samples. The severity of necrosis significantly increased along the increase in rejection severity, reaching 0% at 0R, 0.03% at 1R, 4.95% at 2R and 17.4% at 3R. The most massive hemorrhages were detected in samples attributed to 2R – 9.89% of the biopsy area. Lipomatosis was noted at all levels of rejection, reaching a maximum of 16.5% of the area in patients with 3R. The area of fibrosis increased with an increase in the severity of rejection: at zero degree it was 0.16% of the biopsy, at the first – 3.8%, at the second – 8.69%. Conclusion. The studied morphological indicators make possible a more detailed assessment of the degree, as well as the course of the rejection reaction, which will improve the quality of diagnosis with endomyocardial biopsy.

Keywords

• endomyocardial biopsy
• rejection of transplanted heart
• computer morphometry