Epithelial to mesenchymal transition in endomyocardial biopsies from orthotopic heart transplant recipients

Bistees George, Maria Del Mar Rivera Rolon, Sharma Mohit, Heather Stevenson-Lerner

Research output: Contribution to journalArticle

Abstract

Epithelial to mesenchymal transition (EMT) occurs when cells lose morphological features of epithelial cells, such as cell-to-cell adhesion, and gain features of mesenchymal cells, including elongation and flattening. These cells also lose expression of epithelial immunohistochemical markers. In this report, we present a 55-year-old Caucasian male patient who underwent orthotopic heart transplant and immunosuppressant therapy with tacrolimus and mycophenolic acid. Seven and a half months later, an endomyocardial biopsy revealed a hypercellular, atypical lesion. Evaluation was negative for acute cellular rejection and post-transplant lymphoproliferative disorder. Histopathologic features and immunohistochemical stains were consistent with EMT. We subsequently identified four additional cases of EMT in patients who underwent orthotopic heart transplantation and received a similar immune suppression regimen. EMTs have been reported to occur in lung and kidney allografts; however, this is the first known report describing this entity in a heart transplant recipient.

Original languageEnglish (US)
Article numbere229175
JournalBMJ Case Reports
Volume12
Issue number8
DOIs
StatePublished - Aug 1 2019

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Epithelial-Mesenchymal Transition
Biopsy
Mycophenolic Acid
Lymphoproliferative Disorders
Graft Rejection
Tacrolimus
Heart Transplantation
Immunosuppressive Agents
Cell Adhesion
Allografts
Coloring Agents
Epithelial Cells
Transplants
Kidney
Lung
Transplant Recipients
Therapeutics

Keywords

  • cardiovascular medicine
  • heart failure
  • pathology

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Epithelial to mesenchymal transition in endomyocardial biopsies from orthotopic heart transplant recipients. / George, Bistees; Rolon, Maria Del Mar Rivera; Mohit, Sharma; Stevenson-Lerner, Heather.

In: BMJ Case Reports, Vol. 12, No. 8, e229175, 01.08.2019.

Research output: Contribution to journalArticle

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