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Ann Thorac Surg 1987;43:554-556
© 1987 The Society of Thoracic Surgeons

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Articles

Occlusive Coronary Arteritis: A Cause of Early Death in a Cardiac Transplant Patient

From the Cardiac Transplant Unit and the Division of Cardiovascular Pathology, Texas Heart Institute and St. Luke's Episcopal Hospital, and Department of Surgery and Division of Organ Transplantation, University of Texas Medical School, Houston, TX

Accepted for publication May 9, 1986.

^* Address reprint requests to Dr. Frazier, Texas Heart Institute, PO Box 20345, Houston, TX 77225

A patient died 5 months after undergoing cardiac transplantation. Endomyocardial biopsies performed prior to death showed no evidence of severe rejection. At autopsy, nonnecrotizing occlusive coronary arteritis was present. The intima of the coronary arteries contained numerous lymphocytes and plasma cells. Chronic rejection appeared to be responsible for the arteritis. The onset of coronary occlusive disease is insidious, and recognition depends on the performance of coronary arteriography, which is usually not done until the one-year follow-up. Early coronary arteriography is suggested to rule out occlusive coronary arteritis when cardiac allograft function is not satisfactory, even when the endomyocardial biopsy shows no evidence of rejection.

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