The role of humoral immunity in rejection of cardiac allograft is still not clearly delineated. The retrospective study analysed 81 heart transplant biopsies from 17 patients (14 men, 3 wome, age ...range 25 - 65 years) by light and immunofluorescence microscopy techniques. Positive immunostaining was observed in 54 biopsies. Fine granular or linear immune deposits, consisting of IgG (n=1), IgA (n=9), IgM (n=23), C3 (n=13), C1q (n=2), C4 (n=1), and fibrin/fibrinogen (=6) in the capillary or other small vessel walls were observed in 26 biopsies, homogeneous vessel wall deposition of only C3 or IgM and C3 in 5, focal homogeneous positive reaction of muscle fibres in 6 and positive inflammatory cells in the interstitium in 33 biopsies. Humoral vascular immune rejection was established in 26 biopsies (32.1%) of 8 patients(47.1%) based on immunofluorescence findings of vascular immune deposits and vascular histologic changes and was found in heart transplant samples 2 days to 16 months after transplantation. In conclusion, the observation of characteristic vascular immune deposits, compatible with humoral mechanism of rejection, which were also found in biopsies with no evidenc eof histopathologic changes, provide the rationale to use immunofluorescene in the examination of cardiac graft biopsies.
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