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The AECVP Cardiac Transplant Pathology Network

Website: http://anpat.unipd.it/aecvp/index.php/aecvp-working-group/

Cardiac Transplant Steering Group
Association for European Cardiovascular Pathologists:

Margaret Burke
Harefield Hospital
London, United Kingdom

Ornella Leone
S. Orsola Hospital
Bologna, Italy

Claire Toquet
hôtel-Dieu hospital
Nantes, France

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A Cardiac Transplant Pathology Working Group was established under the auspices of the AECVP in 2008 by Margaret Burke and Annalisa Angelini and was given Steering Committee status in 2012 with the addition of Ornella Leone and Claire Toquet as members.

Our aims are to create a European network of pathologists to discuss current and evolving practice in cardiac transplant pathology; to promote quality control studies in both diagnostic and technical fields; to undertake multi-centre studies on cardiac transplant pathology; and to establish working relationships with sister societies involved in cardiac transplantation. We also seek to establish a referral network for postgraduate educational purposes, especially for pathologists new to this area of practice, and to establish links between cardiac transplant pathologists and transplant cardiologists, immunologists, surgeons and researchers. To date, over 50 pathologists in 17 European countries have registered as Network members.

You are welcome to check out our recently updated Cardiac Transplant Pathology web page on the AECVP website. We have carried out a number of multi-centre projects, including a reproducibility study of the 2005 Working Formulation for cardiac allograft rejection [1], and a survey on technical aspects of C4d immunostaining and its interpretation in the diagnosis of cardiac antibody-mediated rejection (AMR) [2]. Other collaborative projects such as a study of intravascular mononuclear cells in AMR [3] and a survey of autopsy practice in cardiac transplantation are underway. Our website now contains helpful information on diagnostic criteria and laboratory practice in AMR. All European transplant pathologists are welcome to join, whether or not they are members of the AECVP. A membership form can be accessed on the website.

Our work also informed the 2013 ISHLT Working Formulation for pathologic diagnosis of cardiac AMR published in the December 2013 issue of the Journal for Heart and Lung Transplantation [4]. The paper is the result of 5 years of trans-Atlantic collaboration by Pathology Council members, led by Gerry Berry (Stanford, CA) with Margaret Burke and Annalisa Angelini.

Many of us are also members of the North America-based Society for Cardiovascular Pathology (SCVP) and the AECVP Cardiac Transplant Pathology Network. The last 5 years has also seen fruitful collaboration between these two groups several other projects relating to both cardiac and transplant pathology. One is a consensus paper on interpretation of the endomyocardial biopsy in cardiac and transplant pathology [5]. Another is an image-rich web-based tutorial on assessment of endomyocardial biopsies for acute cellular rejection, led by Marc Halushka (Baltimore, MD) of the SCVP and hosted on its website. A tutorial on cardiac antibody-mediated rejection, led by Dylan Miller (Salt Lake City, UT) will follow now that the Working Formulation has been published.

We hope that these ventures will provide opportunities for all ISHLT members to learn about the pathology of cardiac disorders and transplantation as well as stimulate opportunities for collaborative research.

Disclosure Statement: The authors have no conflicts of interest to report.


  1. Angelini A, Andersen CB, Bartoloni G, Black F, Bishop P, Doran H et al. A web-based pilot study of inter-pathologist reproducibility using the ISHLT 2004 working formulation for biopsy diagnosis of cardiac allograft rejection: the European experience. J Heart Lung Transplant 2011; 30(11):1214-1220.
  2. Burke M, Andersen CB, Ashworth M, et al. C4d methodology and interpretation in diagnosis of cardiac antibody-mediated rejection: a European survey from the Association for European Cardiovascular Pathology (AECVP). J Heart Lung Transplant 2010; 29(2):S37-S38.
  3. Fedrigo M, Leone O, Burke M, Rice A, Torbenson M, Toquet C et al. Inflammatory cell burden and phenotype in endomyocardial biopsies from patients with antibody-mediated rejection (AMR) - An AECVP multicenter study. J Heart Lung Transplant. 32[4S], S19. 2013.
  4. Berry GJ, Burke MM, Andersen C, Bruneval P, Fedrigo M, Fishbein MC et al. The 2013 ISHLT Working Formulation for the Standardization of Nomenclature in the Pathologic Diagnosis of Antibody-mediated Rejection in Heart Transplantation. J Heart Lung Transplant 2013; 32(12):1147-1162.
  5. Leone O, Veinot JP, Angelini A, Baandrup UT, Basso C, Berry G et al. 2011 Consensus statement on endomyocardial biopsy from the Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology. Cardiovasc Pathol 2012; 21(4):245-274.

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