Subject(s)
Employee Incentive Plans/organization & administration , Health Behavior , Health Benefit Plans, Employee/organization & administration , Cost Sharing , Efficiency, Organizational , Employee Incentive Plans/economics , Employee Incentive Plans/trends , Employer Health Costs/trends , Health Benefit Plans, Employee/economics , Health Benefit Plans, Employee/trends , Humans , Program Evaluation , Risk Factors , United StatesABSTRACT
On the basis of our experience with prospective observation of immunofluorescence microscopy in 5775 biopsy specimens from 335 consecutively followed heart transplant cases, we describe the immunofluorescent method in detail and the potential artifacts and method of interpretation of the findings. A strategy for use of the method on the basis of the experience of the authors is proposed.
Subject(s)
Fluorescent Antibody Technique , Graft Rejection/diagnosis , Heart Transplantation , Myocardium/metabolism , Complement System Proteins/analysis , Coronary Vessels/immunology , Endocardium/metabolism , Endocardium/pathology , Fibrin/analysis , Fibrinogen/analysis , HLA-DR Antigens/analysis , Humans , Immunoglobulins/analysis , Myocardium/pathology , Prospective StudiesABSTRACT
Although the majority of rejection found in cardiac transplant biopsies is cellular in type, a variety of vascular alterations occur in cardiac biopsies, constituting different forms of rejection that can be recognized using light microscopic and immunopathologic criteria. In this report, pathologic aspects of the vascular alterations associated with vascular and mixed rejection of cardiac allografts are described in detail. Methods and controls used in this report are identical to those previously reported. The histologic, immunopathologic, and ultrastructural findings associated with vascular rejection and other vascular processes in cardiac allografts are discussed. The relationship of these findings to chronic allograft rejection and potential pathogenetic mechanisms of these vascular changes are also detailed.
