1571 specimens taken at 493 occasions for endomyocardial biopsy in 30 selected heart transplant patients were reexamined in order to assess (a) the difference between conventional (steroid, azathioprine and antithymocyte globulin) and cyclosporine with low-dose steroid immunosuppression regimes, and (b) the relationship of myocardial rejection to endocardial infiltrates, the Quilty lesion, and changes in the small intramyocardial blood vessels. The incidence of all histological changes discussed were related to the severity of the myocardial rejection and therefore the endocardial and vascular changes may be used as adjuvants to make good any technical deficiencies in the myocardial part of the biopsy. Cyclosporine therapy is associated with the Quilty effect and with changes in small vessels.
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