Pathologic Grading of Cellular Rejection in a Cardiac Transplant from the Utah Cardiac Transplant Program

Histologic Features

Rejection

Grade

no lymphoid infiltrates OR lymphoid infiltrates confined to scar

none

1

small foci of lymphoid cells; slight linear hypercellularity in the interstitium

cannot rule out

2

single large focus of plump lymphocytes perimyocytic or perivascular

focal mild

2.5

multiple foci of plump lymphocytes perimyocytic or perivascular OR single focus of plump lymphocytes with distortion of myocytes

mild

3.0

multiple foci of plump lymphocytes perimyocytic or perivascular with distortion of myocytes

moderate

4.0

extensive infiltrates of lymphocytes, plasma cells and neutrophils; extensive myocyte distortion; edema and hemorrhage present

severe

5.0