Quilty Effect: Its Definition and Significance, in Post-Cardiac Transplant Endomyocardial Biopsies with Focus on Our Experience

Background: The recent trend of cardiac transplantation has been dramatic in our center, thus entailing the interpretation of endomyocardial biopsies in such patients. Objectives: With this fact borne in mind, we decided to review the cases from the point of view of a certain diagnostic challenge, namely quilty lesion or effect. Methods: From April 2010 to December 2012, 42 patients with heart transplant have undergone endomyocardial biopsies and 63 samples were acquired. Results: Mean age of the patients was 30 ± 15.7 years (male/female: 34/8). Quilty effect was seen in 8 out of 63 samples (12.7%). Conclusions: The incidence of quilty lesion was within the range defined for this finding. When the lesion extends to the underlying myocardial tissue, it can be a diagnostic challenge. In the eyes of an inexperienced observer, ISHLT grade 2 rejection may be diagnosed instead of invasive quilty lesion. Therefore, experienced pathologists play an important role in this regard in all the cardiovascular transplantation sites.