Acute Humoral Rejection 12 Days Post-Heart Transplantation with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antigen Expression in Myocardial Tissue: A Clinical Case.

IF 0.6 Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir Pub Date : 2024-12-01 DOI:10.5543/tkda.2023.64627

Igor Alexandrovich Makarov, Ekaterina Goncharova, Irina Danilova, Mitrofanova Lubov

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Abstract

The development of acute humoral rejection (AMR) in transplanted organs remains a highly relevant and unresolved issue. This study presents a clinical case of heart transplantation (HT) in a patient with hypertrophic cardiomyopathy transitioning to a restrictive phenotype amid chronic lymphocytic myocarditis. Following HT, the patient developed nosocomial pneumonia, necessitating a reduction in immunosuppressive therapy. On the 12th day post-transplantation, the patient experienced a sudden hemodynamic collapse, which proved fatal. Autopsy examination revealed acute humoral rejection with a predominance of CD16+ cells in the infiltrate, exhibiting high expression of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Spike protein on the endothelium and CD16+ cells. Further investigation is required to clarify the role of SARS-CoV-2 in potentially exacerbating AMR development.

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严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）抗原在心肌组织表达的心脏移植术后12天急性体液排斥反应一例

急性体液性排斥反应（AMR）在移植器官中的发展仍然是一个高度相关和未解决的问题。本研究提出了一个临床病例心脏移植（HT）患者肥厚性心肌病过渡到限制性表型慢性淋巴细胞性心肌炎。HT后，患者发生院内肺炎，需要减少免疫抑制治疗。在移植后的第12天，患者经历了突然的血流动力学崩溃，这证明是致命的。解剖检查显示急性体液性排斥反应，浸润细胞中CD16+细胞占主导地位，内皮细胞和CD16+细胞上高表达严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）刺突蛋白。需要进一步调查以阐明SARS-CoV-2在可能加剧抗菌素耐药性发展中的作用。

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Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir

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