Transplant coronary heart disease: Challenges and solutions

Jentzer, JC and Hickey, GW and Khandhar, SJ (2014) Transplant coronary heart disease: Challenges and solutions. Transplant Research and Risk Management, 6. 117 - 127.

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Abstract

Cardiac allograft vasculopathy (CAV) remains one of the leading causes of death and graft failure after heart transplantation. A variety of causes, including donor heart characteristics, recipient risk factors, and immune-mediated influences, are associated with developing CAV. In this review, we will focus on the pathophysiology of developing CAV and various methods to screen for this condition. The pathogenesis of CAV likely involves repeated injuries to the endothelium from a variety of factors such as cellular-mediated rejection, and alloimmune factors, including antibody-mediated injury, ischemia-reperfusion injury at time of transplant, cytomegalovirus infections, immunosuppression medications, systemic inflammation, and tra­ditional atherosclerosis risk factors. Patients with significant CAV are often asymptomatic, and therefore early detection by routine screening prior to graft dysfunction is crucial. There are a variety of invasive, noninvasive, and blood tests that have been studied as screening methods, and we will discuss the role of each of these in this review article. Although some treatment regimens have been established for CAV, this is an area where further studies and research are necessary.

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Details

Item Type:	Article
Status:	Published
Creators/Authors:	Creators Email Pitt Username ORCID Jentzer, JC Hickey, GW Khandhar, SJ
Date:	11 December 2014
Date Type:	Publication
Journal or Publication Title:	Transplant Research and Risk Management
Volume:	6
Page Range:	117 - 127
DOI or Unique Handle:	10.2147/trrm.s50846
Refereed:	Yes
Article Type:	Review
Date Deposited:	09 Apr 2015 19:01
Last Modified:	27 Mar 2021 09:55
URI:	http://d-scholarship.pitt.edu/id/eprint/24692

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