Rejection is characterized by interstitial lymphocytic inflammation, myocyte damage and a histologic pattern similar to that seen in viral myocarditis. Both T celland antibody responses to the allograft are involved in the rejection reaction.
Allograft arteriopathy is the single most important longterm limitation for cardiac transplantation. It is marked by late, progressive, diffusely stenosing intimal proliferation in the coronary arteries, leading to ischemic injury.
Despite these problems, the outlook for transplant recipients generally is good, with a 1-year survival rate of 90% and a 5-year survival rate of more than 70%.
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