ТРАНСПЛАНТИРОВАННОЕ СЕРДЦЕ. ПРАВОЖЕЛУДОЧКОВАЯ НЕДОСТАТОЧНОСТЬ, ОТТОРЖЕНИЕ ИЛИ МИОКАРДИТ?

The differentiation of the cases of the right ventricular failure in transplanted heart should be complex and challenging. The 28-year old man with dilated cardiomyopathy underwent orthotopic heart transplantation. After transplantation developed right ventricular failure. The biopsy (n = 5) didn’t reveal any signs of myocardial rejection. There were noted some signs of in fl ammation in lateral right ventricular wall only by gated SPECT. The right ventricular failure increased and 6 months later there was successfully performed the heart retransplantation on the patient. The virusological study revealed the Epstein–Barr virus in myocardium. The explanted heart research excluded limphoproliferative disease by immunogystochemical tests. The fi nal diagnosis is myocarditis.