ABSTRACT
Cardiac transplantation is an established therapeutic modality for end stage heart disease. Over 36,000 cardiac transplants had been performed worldwide between 1967 and 2000. With refinement of techniques of surgery, postoperative care, selection criteria of donors, care in transportation of hearts, revolution in immunosuppressive therapy and most importantly use of endomyocardial biopsy has provided improved survivals. Endomyocardial biopsy has contributed importantly to success of cardiac transplantation programme. Sequential biopsies can be performed with ease and safety and provide basis for diagnosis and monitoring of allograft rejection. Microvasculature is affected which is best appreciated by demonstration of immune complexes either by immunofluorescence or immunohisto-chemistry. Light microscopically, endothelialitis and/or vasculitis may be demonstrated. Inflammatory infiltrate in infections may at times pose a difficulty in interpretation of rejection. Management is by reduction of immunosuppressive therapy and treatment with antiviral agents. The other types of malignancy related to immunosuppressive therapy include squamous cell carcinoma of the skin, lip, vulva, cervix, perineum and Kaposi's sarcoma.
