RADIOLOGIC ASPECTS OF CARDIAC TRANSPLANTATION

Abstract

Increase in heart size is the earliest radiologic sign of rejection in most cases. Small pleural effusions are common. In acute rejection the postoperative changes do not resolve but worsen rapidly, whereas in chronic rejection the postoperative changes may resolve rapidly, only to be followed at a long interval by cardiac dilatation. Pulmonary edema and pulmonary venous congestion are lacking or slight, in distinction to other forms of cardiac failure. Other radiological features are related to complications incident to immunosuppressive therapy, such as infections, gastrointestinal bleeding, and osteoporosis. Although the previous enthusiasm regarding cardiac transplantation has been considerably dampened, the experience gained in this effort has been invaluable; it has clarified concepts of and has stimulated research into immunologic responses. It has provided information not only regarding the surgical technique of transplantation but also regarding the pathologic changes and radiologic features which accompany rejection. The accomplishments in the understanding of immunologic processes during the past few years have been remarkable and future years offer exciting potentialities especially in the field of tumor research. Unquestionably, the future of organ transplantation lies in the field of immunology.