Pediatric Heart Transplant Rejection After COVID-19 Infection

Abstract

Background: Infections have been associated with rejection episodes in solid organ transplant recipients. We report an association between COVID-19 infection and heart transplant (HT) rejection.

Case description: The patient was 14 years old and 6.5 years post-HT. He developed symptoms of rejection within 2 weeks of COVID exposure and presumed infection.

Conclusions: In this case, COVID-19 infection closely preceded significant rejection and graft dysfunction. Further study is needed to establish a correlation between COVID-19 infection and rejection in HT patients.

Figure 1

Patient Class 1 Donor Specific Antibody Levels since transplantation

Figure 2

Patient Class 2 Donor Specific Antibody Levels since transplantation

Figure 3

Hematoxylin eosin-stained slide shows mild endocardial and interstitial mononuclear infiltrate of the myocardial biopsy.

Figure 4

C4d immunostain shows focal weak linear vascular staining of the myocardial biopsy.