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Diagnosis and Management of Cardiac Allograft Vasculopathy (Chronic Rejection)

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The Transplantation and Replacement of Thoracic Organs

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Abstract

The greatest impediment to long-term survival for adult and pediatric heart transplant recipients is the development of an accelerated form of coronary artery disease[1]–[4]. This is variously termed chronic allograft vasculopathy, chronic allograft coronary artery disease, or chronic rejection. This disease was reported in the original preclinical animal experiments, and subsequently in the early human heart transplant recipients at Stanford, USA 6.7 and Cape Town, South Africa”. The incidence of this disease has been estimated at 10% per year post-transplant[4],[9]’[11]. Although cyclosporin has been associated with an improvement in 1- and 5-year graft survival, as well as a decrease in death due to rejection, it has not had an impact on reducing the incidence of allograft coronary artery disease (ACAD)[12]’[15] in adults, but increased immunosuppression may decrease the incidence in pediatric patients[15].

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Authors
  1. L. W. Miller
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  2. T. Donahue
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  3. T. Wolford
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  4. J. Drury
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Editor information

Editors and Affiliations

  1. Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston

    David K. C. Cooper MA, PhD, MD, MS, FRCS, FACC, FACS

  2. Oklahoma Medical Research Foundation, Oklahoma City, USA

    David K. C. Cooper MA, PhD, MD, MS, FRCS, FACC, FACS

  3. St Louis University Health Sciences Center, St Louis, USA

    Leslie W. Miller MD, FACC

  4. Washington University School of Medicine, St Louis, USA

    G. Alexander Patterson MD, FRCS(C), FACS

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© 1996 Kluwer Academic Publishers

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Miller, L.W., Donahue, T., Wolford, T., Drury, J. (1996). Diagnosis and Management of Cardiac Allograft Vasculopathy (Chronic Rejection). In: Cooper, D.K.C., Miller, L.W., Patterson, G.A. (eds) The Transplantation and Replacement of Thoracic Organs. Springer, Dordrecht. https://doi.org/10.1007/978-0-585-34287-0_35

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  • DOI: https://doi.org/10.1007/978-0-585-34287-0_35

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