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Extracellular matrix (ECM) remodeling in explanted hearts: Differences between right and left ventricular localisations?
Posters: Transplantation Pathology / Pathology - Research and Practice 200 (2004) 273-276
Results: Within approx. 2 hours after sample arrival, this procedure visualizes the PV as naked icosahedral particles of approx. 45 to 50-nm in diameter. We report the results of the EM examination of such specimens in the clinical context of impaired renal allograft recipients. The influence of prolonged sample storage, freezing, and application of the agar enrichment method on the virus structure preservation and detection incidence will be demonstrated. Conclusion: The negative staining of urine samples from clinically suspected PAN patients is a rapid, non-invasive, relatively inexpensive method to detect a PV infection early. It is also a valuable strategy for following transplant recipients with biopsy-documented PV-infections, particularly as a means of monitoring response to reduction in immunotherapy.
275
Results: The Mortality in the first three years is higher, than in the period between three and five years.The observation stops with 5 years. During the first year, primary graft failure and infections (fungal, bacterial, and mixed infections) are the most important reasons for premature death. In the period 1 between 5 years is the cause of mortality principal rejection, suizides, malignancies and graft arteriosclerosis. Conclusions: The mortality after heart transplantation is high in the fist year after surgery. The main reasons are graft failure and infections.
82 Pulmonary complications after allogeneie bone marrow transplantation - an open lung biopsy study
O U Extracellular matrix (ECM) Remodeling in explanted hearts: Differences between right and left ventricular localisations? E. HERPEL, C. FLECHTENMACHER, S. SINGER, M. PRITSCH 1, F.-U. SACK 2, M. HAASS 3, H.F. OTTO, PH. A. SCHNABEL Pathologisches Institut, Universit~t Heidelberg Institut ftir Biometrie und Informatik, Universit~it Heidelberg z Herzchirurgie, Universit~it Heidelberg 3Kardiologie,Theresienkrankenhaus, Mannheim
Aims: An altered composition of ECM due to remodeling interferes with myocardial function. We investigated wether the expression of matrix proteins and matrix metalloproteinases (MMPs) varies between right and left ventricular localisations. Methods: From 33 explanted human hearts (18 patients with ischemic and 15 with dilated cardiomyopathy) transmural samples were taken from right ventricle, septum and left ventricular apex and base. Immunohistochemistry was performed on kryosections using antibodies against collagen type I, III, IV, laminin, fibronectin and MMP-1, -2, -9. The volume densities of matrix proteins were measured by the point-counting method. MMP expressions were determined as cells/ram2. Results: Statistically significant differences between right and left ventricular localisations were found for collagen type I, IV, laminin and fibronectin. Statistical testing showed that comparing the different left ventricular localisations, values for matrix proteins and MMPs were not identical. Conclusions: The remodeling process in end-stage cardiomyopathies is different between right and left ventricular myocardium. Even in the different left ventricular localisations remodeling is not equal. Therefore further studies should be performed only on identical localisations within the same ventricle/s.
I. BITTMANN, C. MOLLER 1, G. MICHELEW, J. KOLB 2, G. J)kGER 3, U. L()HRS Pathologisches Institut, Ludwig-Maximilians-Universit/it Mtinchen 1Chirurgische Klinik und Poliklinik, Klinikum Groghadem 2Medizinische Klinik III, Klinikum Groghadem 3Max von Pettenkofer Institut, Lehrstuhl Virologie
Aims: Pulmonary complications are important causes of morbidity and mortality in patients after allogeneic bone marrow transplantation (BMT). Pulmonary complications after BMT may be due to infectious or non-infectious conditions. It is not clearly defined whether an acute graft versus host reaction (GvHR) of the lung exists. Methods: Open lung biopsies (n = 49) of patients (n = 49) with hematologic malignancies and allogeneic bone marrow transplantation. Light microscopic evaluation and immuno-histochemistry (IHC) with antibodies against adenovirus and cytomegaly virus. Clinico-pathological correlation of morphological changes and diagnostic findings of microbiology. Results: Most of the pulmonary complications took place >100 days post transplantation (ptx) and after high-dose chemotherapy and radiation. The most common pulmonary injury was a diffuse alveolar damage (DAD), less frequently interstitial pneumonia (IP) and non-specific changes could be observed. DAD was in a high percentage (46.8%) associated with parallel microbiological detection of adenovirus. Adenovirus could not be detected by IHC. Furthermore HHV6 was found microbiologically in 34.8% of cases with different pulmonary changes including non-specific alterations. Conclusions: DAD was the most common pulmonary injury after allogeneic BMT. The only possible manifestation of acute GvHR could be IP. The clinical significance of microbiological detection of adenovims and HHV6 remains uncertain.
81
A study retrospectively about Mortality, Morbidity, clinical data and causes of death in a period of 17 years after heart transplantation R. KUHLY, R. MEYER, R. HETZER Deutsches Herzzentrum Berlin
Aims: To study retrospectively patients after heart transplantation with respect initial diagnosis, cause of death, mortality, morbidity, clinical parameters and results of autopsy. Methods: 680 patients died after heart transplantation in the period from 1986 to 2003 and were included in the study with or without autopsy.
83 Primary bronchogenic carcinoma after unilateral lung transplantation with metastasis in the transplant lung K. SCHLIRFELD 1, M. FRANK 1, CH. FELLBAUM j, CH. VON MALLINCKRODT 2, H.J. ACHENBACH 2, C. KUHNEN 3, K.M. MfQLLER 3, M.L. HANSMANN 1 Institut fttr Pathologie ~und Innere Medizin2, Universit~it Frankfurt BG Kliniken Bergmannsheil, Institut f'tir Pathologie, Bochum 3
Aims: Presented are the autopsy findings of a 62-year-old man who developed squamous cell carcinoma in the native lung two years after single lung transplantation for idiopathic pulmonary fibrosis.
Results: Within approx. 2 hours after sample arrival, this procedure visualizes the PV as naked icosahedral particles of approx. 45 to 50-nm in diameter. We report the results of the EM examination of such specimens in the clinical context of impaired renal allograft recipients. The influence of prolonged sample storage, freezing, and application of the agar enrichment method on the virus structure preservation and detection incidence will be demonstrated. Conclusion: The negative staining of urine samples from clinically suspected PAN patients is a rapid, non-invasive, relatively inexpensive method to detect a PV infection early. It is also a valuable strategy for following transplant recipients with biopsy-documented PV-infections, particularly as a means of monitoring response to reduction in immunotherapy.
275
Results: The Mortality in the first three years is higher, than in the period between three and five years.The observation stops with 5 years. During the first year, primary graft failure and infections (fungal, bacterial, and mixed infections) are the most important reasons for premature death. In the period 1 between 5 years is the cause of mortality principal rejection, suizides, malignancies and graft arteriosclerosis. Conclusions: The mortality after heart transplantation is high in the fist year after surgery. The main reasons are graft failure and infections.
82 Pulmonary complications after allogeneie bone marrow transplantation - an open lung biopsy study
O U Extracellular matrix (ECM) Remodeling in explanted hearts: Differences between right and left ventricular localisations? E. HERPEL, C. FLECHTENMACHER, S. SINGER, M. PRITSCH 1, F.-U. SACK 2, M. HAASS 3, H.F. OTTO, PH. A. SCHNABEL Pathologisches Institut, Universit~t Heidelberg Institut ftir Biometrie und Informatik, Universit~it Heidelberg z Herzchirurgie, Universit~it Heidelberg 3Kardiologie,Theresienkrankenhaus, Mannheim
Aims: An altered composition of ECM due to remodeling interferes with myocardial function. We investigated wether the expression of matrix proteins and matrix metalloproteinases (MMPs) varies between right and left ventricular localisations. Methods: From 33 explanted human hearts (18 patients with ischemic and 15 with dilated cardiomyopathy) transmural samples were taken from right ventricle, septum and left ventricular apex and base. Immunohistochemistry was performed on kryosections using antibodies against collagen type I, III, IV, laminin, fibronectin and MMP-1, -2, -9. The volume densities of matrix proteins were measured by the point-counting method. MMP expressions were determined as cells/ram2. Results: Statistically significant differences between right and left ventricular localisations were found for collagen type I, IV, laminin and fibronectin. Statistical testing showed that comparing the different left ventricular localisations, values for matrix proteins and MMPs were not identical. Conclusions: The remodeling process in end-stage cardiomyopathies is different between right and left ventricular myocardium. Even in the different left ventricular localisations remodeling is not equal. Therefore further studies should be performed only on identical localisations within the same ventricle/s.
I. BITTMANN, C. MOLLER 1, G. MICHELEW, J. KOLB 2, G. J)kGER 3, U. L()HRS Pathologisches Institut, Ludwig-Maximilians-Universit/it Mtinchen 1Chirurgische Klinik und Poliklinik, Klinikum Groghadem 2Medizinische Klinik III, Klinikum Groghadem 3Max von Pettenkofer Institut, Lehrstuhl Virologie
Aims: Pulmonary complications are important causes of morbidity and mortality in patients after allogeneic bone marrow transplantation (BMT). Pulmonary complications after BMT may be due to infectious or non-infectious conditions. It is not clearly defined whether an acute graft versus host reaction (GvHR) of the lung exists. Methods: Open lung biopsies (n = 49) of patients (n = 49) with hematologic malignancies and allogeneic bone marrow transplantation. Light microscopic evaluation and immuno-histochemistry (IHC) with antibodies against adenovirus and cytomegaly virus. Clinico-pathological correlation of morphological changes and diagnostic findings of microbiology. Results: Most of the pulmonary complications took place >100 days post transplantation (ptx) and after high-dose chemotherapy and radiation. The most common pulmonary injury was a diffuse alveolar damage (DAD), less frequently interstitial pneumonia (IP) and non-specific changes could be observed. DAD was in a high percentage (46.8%) associated with parallel microbiological detection of adenovirus. Adenovirus could not be detected by IHC. Furthermore HHV6 was found microbiologically in 34.8% of cases with different pulmonary changes including non-specific alterations. Conclusions: DAD was the most common pulmonary injury after allogeneic BMT. The only possible manifestation of acute GvHR could be IP. The clinical significance of microbiological detection of adenovims and HHV6 remains uncertain.
81
A study retrospectively about Mortality, Morbidity, clinical data and causes of death in a period of 17 years after heart transplantation R. KUHLY, R. MEYER, R. HETZER Deutsches Herzzentrum Berlin
Aims: To study retrospectively patients after heart transplantation with respect initial diagnosis, cause of death, mortality, morbidity, clinical parameters and results of autopsy. Methods: 680 patients died after heart transplantation in the period from 1986 to 2003 and were included in the study with or without autopsy.
83 Primary bronchogenic carcinoma after unilateral lung transplantation with metastasis in the transplant lung K. SCHLIRFELD 1, M. FRANK 1, CH. FELLBAUM j, CH. VON MALLINCKRODT 2, H.J. ACHENBACH 2, C. KUHNEN 3, K.M. MfQLLER 3, M.L. HANSMANN 1 Institut fttr Pathologie ~und Innere Medizin2, Universit~it Frankfurt BG Kliniken Bergmannsheil, Institut f'tir Pathologie, Bochum 3
Aims: Presented are the autopsy findings of a 62-year-old man who developed squamous cell carcinoma in the native lung two years after single lung transplantation for idiopathic pulmonary fibrosis.