Epithelial to mesenchymal transition in endomyocardial biopsies from orthotopic heart transplant recipients.
Bistees GeorgeMaria Del Mar Rivera RolonSharma MohitHeather L StevensonPublished in: BMJ case reports (2019)
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.
Keyphrases
- induced apoptosis
- cell cycle arrest
- epithelial mesenchymal transition
- end stage renal disease
- heart failure
- chronic kidney disease
- stem cells
- single cell
- atrial fibrillation
- cell death
- signaling pathway
- poor prognosis
- bone marrow
- newly diagnosed
- cell therapy
- peritoneal dialysis
- prognostic factors
- epstein barr virus
- respiratory failure
- cell proliferation
- long non coding rna
- pi k akt
- mesenchymal stem cells
- drug induced
- extracorporeal membrane oxygenation
- patient reported
- fine needle aspiration