{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:33Z","timestamp":1756425813884,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,6,28]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>Epithelial to mesenchymal transition (EMT) occurs when cells lose morphological features of epithelial cells, such as cell-to-cell adhesion, and gain features of mesenchymal cells, including elongation and flattening. These cells also lose expression of epithelial immunohistochemical markers. In this report, we present a 55-year-old Caucasian male patient who underwent orthotopic heart transplant and immunosuppressant therapy with tacrolimus and mycophenolic acid. Seven and a half months later, an endomyocardial biopsy revealed a hypercellular, atypical lesion. Evaluation was negative for acute cellular rejection and post-transplant lymphoproliferative disorder. Histopathologic features and immunohistochemical stains were consistent with EMT. We subsequently identified four additional cases of EMT in patients who underwent orthotopic heart transplantation and received a similar immune suppression regimen. EMTs have been reported to occur in lung and kidney allografts; however, this is the first known report describing this entity in a heart transplant recipient.<\/jats:p>","DOI":"10.1136\/bcr-2018-229175","type":"journal-article","created":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T04:44:02Z","timestamp":1566535442000},"page":"e229175","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Epithelial to mesenchymal transition in endomyocardial biopsies from orthotopic heart transplant recipients"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6965-2416","authenticated-orcid":false,"given":"Bistees","family":"George","sequence":"first","affiliation":[{"name":"Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Del Mar","family":"Rivera Rolon","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharma","family":"Mohit","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Texas Medical Branch, Galveston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0645-7621","authenticated-orcid":false,"given":"Heather L","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,8,22]]},"reference":[{"key":"2025082802204293000_12.8.e229175.1","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.5858\/2007-131-1169-UOCTP","article-title":"Update on cardiac transplantation pathology","volume":"131","author":"Tan","year":"2007","journal-title":"Arch Pathol Lab Med"},{"key":"2025082802204293000_12.8.e229175.2","unstructured":"Hui-Min Y , Lai CK . 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