Grade 2 Cardiac Rejection Pathologic and Clinical Controversies

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A cute rejection and its treatment remain important causes of morbidity and mortality after heart transplantatin. A single focus of rejection, International Society for Heart and Lung Trasplantation grade 2 which canbe present on an endomyocardia biopsy specimen, evokes discussion and often disagreement among pathologists and clinicians. Pathologically, this biopsy finding must be differentiated form other gradesof rejection and from previous biopsy sites, ischemic injury, Quilty effect, infection, and post-transplant lymphoproliferative disorders involving the allograft. Once a diagnosis of grade 2 rejection is rendered, clinical response varics widely between transplant centers.

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