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Allograft vasculopathy

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https://www.readbyqxmd.com/read/29664432/disseminated-adenovirus-infection-in-heart-and-kidney-transplant
#1
Jack Xu, Keval V Patel, Melroy Dsouza, Jesus Almendral, Kanika Mody, Deepa Iyer
Presently described is a case of disseminated adenovirus infection in a heart-kidney transplant recipient that was successfully treated with cidofovir. There are several reports of adenovirus infections in adult solid organ transplant recipients and the prognosis is usually poor, with mortality rates of 40% to 60%. Severe disseminated adenovirus infections have been associated with increased risk of adverse transplant events, such as rejection, ventricular dysfunction, allograft vasculopathy, graft loss, and the need for re-transplantation...
April 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29649585/effects-of-different-serotonin-receptor-subtype-antagonists-on-the-development-of-cardiac-allograft-vasculopathy-in-murine-aortic-allografts
#2
Annika Gocht, Jörg H W Distler, Bernd Spriewald, Martina Ramsperger-Gleixner, Michael Weyand, Stephan M Ensminger, Christian Heim
BACKGROUND: Cardiac allograft vasculopathy (CAV) is the main obstacle for long-term survival after heart transplantation. Alloimmune mediated chronic vascular rejection results in several mechanisms like platelet activation, immigration of inflammatory cells through the endothelial layer and proliferation and migration of smooth muscle cells (SMCs). Serotonin (5-HT) promotes these processes via activation of 5-HT2 receptors. We hypothesized that inhibiting 5-HT2 receptors ameliorates the development of CAV...
April 9, 2018: Transplant Immunology
https://www.readbyqxmd.com/read/29626851/antibody-mediated-rejection-induced-cardiogenic-shock-too-late-for-conventional-therapy
#3
Guillaume Coutance, Lucas Van Aelst, Guillaume Hékimian, Charles Vidal, Philippe Rouvier, Samir Saheb, Chantal Gautreau, Pascal Leprince, Shaida Varnous
BACKGROUND: Data are scarce on the prognosis of heart allograft antibody-mediated rejection (AMR) with cardiogenic shock (CS). METHODS: We performed a retrospective, single center, observational study. We included patients with biopsy proven AMR and CS. We aimed to analyze the characteristics, treatment and prognosis of patients treated for CS due to AMR. Patients alive after AMR were followed to analyze recurrences of AMR, graft function and cardiac allograft vasculopathy (CAV)...
April 7, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29620542/donor-specific-hla-dq-antibodies-may-contribute-to-poor-graft-outcome-after-heart-transplantation
#4
Osama Omrani, Moheeb Alawwami, Jehad Buraiki, Nedim Selimovic
BACKGROUND: HLA-DQ donor-specific antibodies (DSA) are implicated in allograft dysfunction after renal and lung transplantation. Limited data exists on the impact of HLA-DQ antibodies on heart transplant patients. OBJECTIVE: To investigate the impact of DSA formation on allograft function and outcomes in heart transplant patients. DESIGN: Retrospective cohort study. SETTING: Collating post-transplantation patient data from computerized database in a tertiary hospital in Riyadh, Saudi Arabia from January 2006 to October 2014...
March 2018: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29605470/outcomes-associated-with-mammalian-target-of-rapamycin-mtor-inhibitors-in-heart-transplant-recipients-a-meta-analysis
#5
Douglas L Jennings, Nicholas Lange, Michael Shullo, Farhana Latif, Susan Restaino, Veli K Topkara, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Maryjane Farr, Paolo Colombo, William L Baker
BACKGROUND: Data evaluating mTOR inhibitor use heart transplant (HT) patients comes from relatively small studies and controversy exists regarding their specific role. We performed a meta-analysis of randomized trials to evaluate the efficacy and safety of mTOR inhibitors in HT patients. METHODS: We performed a systematic literature search of Medline and Embase through July 2017 identifying studies evaluating mTOR inhibitors in HT patients reporting effects on coronary allograft vasculopathy (CAV), renal function, acute cellular rejection (ACR), cytomegalovirus (CMV) infection, and discontinuation due to adverse drug events (ADE)...
March 24, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29603413/optimal-low-density-lipoprotein-concentration-in-cardiac-allograft-vasculopathy
#6
J R Harris, J J Teuteberg, M A Shullo
Cardiac allograft vasculopathy is a major risk factor influencing graft loss and patient survival following orthotopic heart transplant. Allograft vasculopathy is a multifactorial process which includes both immunologic and non-immunologic mechanisms. Given the non-immunological risk factors for vasculopathy, particularly hyperlipidemia, it is intuitive that reducing a patient's LDL would help attenuate the disease process. Multiple studies have shown benefits with the use of statin therapy. However, current heart transplant guidelines do not give a specific recommendation as to what LDL goal should be achieved in this patient population...
March 30, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29598866/functional-and-structural-alterations-in-cardiac-allograft-vasculopathy
#7
EDITORIAL
Michael Weis
No abstract text is available yet for this article.
April 3, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29598865/pet-assessment-of-epicardial-intimal-disease-and-microvascular-dysfunction-in-cardiac-allograft-vasculopathy
#8
Sharon Chih, Aun Yeong Chong, Fernanda Erthal, Robert A deKemp, Ross A Davies, Ellamae Stadnick, Derek Y So, Christopher Overgaard, George Wells, Lisa M Mielniczuk, Rob S B Beanlands
BACKGROUND: Cardiac allograft vasculopathy (CAV) is a leading cause of graft failure and death after heart transplantation. Absolute myocardial blood flow (MBF) quantification using rubidium 82 (Rb-82) positron emission tomography (PET) could enable evaluation of diagnostically challenging diffuse epicardial and microvascular disease in CAV. OBJECTIVES: The authors aimed to evaluate Rb-82 PET detection of CAV. METHODS: Consecutive transplant recipients undergoing coronary angiography were prospectively evaluated with PET, multivessel intravascular ultrasound (IVUS), and intracoronary hemodynamics...
April 3, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29598855/role-of-percutaneous-coronary-intervention-in-the-treatment-of-cardiac-allograft-vasculopathy
#9
Michael S Lee, Gentian Lluri, Will Finch, Kyung Woo Park
We evaluated our quarter-century experience with percutaneous coronary intervention (PCI) in patients with cardiac allograft vasculopathy (CAV). CAV is a progressive form of atherosclerosis that is characterized by diffuse intimal thickening. It is a major cause of morbidity and mortality after orthotopic heart transplantation (OHT). Effective treatment options are limited. PCI has been used as a palliative treatment in selected patients. We retrospectively analyzed 140 patients with CAV who underwent PCI from 1992 to 2017 at the University of California, Los Angeles (UCLA) Medical Center...
February 6, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29595082/a-case-report-of-drug-eluting-balloon-as-a-new-treatment-option-for-cardiac-allograft-vasculopathy
#10
Dario Gulin, Edvard Galic, Jozica Sikic
No abstract text is available yet for this article.
January 1, 2018: Progress in Transplantation
https://www.readbyqxmd.com/read/29577455/diminished-impact-of-cmv-infection-on-graftvasculopathy-development-in-the-antiviral-prophylaxis-era
#11
Johannes Goekler, Andreas Zuckermann, Alexandra Kaider, Philipp Angleitner, Emilio Osorio-Jaramillo, Roxana Moayedifar, Keziban Uyanik-Uenal, Frieda-Marie Kainz, Marco Masetti, Guenther Laufer, Arezu Z Aliabadi-Zuckermann
BACKGROUND: Evidence concerning an association between cytomegalovirus (CMV) infection and accelerated cardiac allograft vasculopathy (CAV) is inconclusive. METHODS: Data were analyzed retrospectively from 297 consecutive heart transplants between 1.1.2002 and 31.12.2012. Patients ≤ 18 years of age, survival and follow-up ≤ 1-year post-transplant and patients with early CAV were excluded. CMV-infection was diagnosed and monitored closely in the first year. CAV was diagnosed by coronary angiography via left heart catheterization and results were categorized according to the International Society of Heart and Lung Transplantation (ISHLT) scoring system...
March 26, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29556146/effects-of-older-donor-age-and-cold-ischemic-time-on-long-term-outcomes-of-heart-transplantation
#12
Heidi J Reich, Jon A Kobashigawa, Tamar Aintablian, Danny Ramzy, Michelle M Kittleson, Fardad Esmailian
Using older donor hearts in cardiac transplantation may lead to inferior outcomes: older donors have more comorbidities that reduce graft quality, including coronary artery disease, hypertension, diabetes mellitus, and dyslipidemia. Shorter cold ischemic times might overcome the detrimental effect of older donor age. We examined the relationship between donor allograft age and cold ischemic time on the long-term outcomes of heart transplant recipients. rom 1994 through 2010, surgeons at our hospital performed 745 heart transplantations...
February 2018: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/29527999/prevalence-and-angiographic-characteristics-of-coronary-vasospasm-detected-at-surveillance-coronary-angiograms-among-patients-with-heart-transplants
#13
Neslihan Arzu Akgün, Orçun Çiftci, Kerem Can Yılmaz, Emir Karaçağlar, Alp Aydınalp, Atilla Sezgin, I Haldun Müderrisoğlu, Mehmet Haberal
OBJECTIVES: Coronary vasospasm in heart transplant recipients occurs through various mechanisms. It has been linked to allograft rejection and coronary vasculopathy, which can result in mortality during follow-up. Here, we investigated the prevalence of coronary vasospasm among heart transplant recipients undergoing surveillance coronary angiography procedures. MATERIALS AND METHODS: This study was prospectively performed at Başkent University Faculty of Medicine by retrospectively analyzing medical information of patients who underwent bicaval heart transplant between 2003 and 2016 and subsequently had coronary angiography to rule out allograft vasculopathy...
March 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29527990/pretransplant-renal-arterial-vasculopathy-of-donor-predicts-poor-renal-allograft-survival
#14
B Handan Özdemir, F Nurhan Özdemir, Pelin Börcek, Çiğdem Sercan, Gökçe Özdemir, Ebru H Ayvazoğlu Soy, Mehmet Haberal
OBJECTIVES: Transplant vasculopathy is a significant predictor of poor outcome. We investigated whether age or pretransplant renal arterial vasculopathy of grafted kidneys affected allograft survival. MATERIALS AND METHODS: This study included 148 recipients and their donors. All donors underwent pretransplant renal arterial biopsy, with renal artery vascular score determined for each artery. Chronic rejection and graft loss were noted for all patients. RESULTS: Variable grades of pretransplant renal arterial lesions were noted in 103 donors (69...
March 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29509573/specific-immunity-to-cytomegalovirus-in-pediatric-cardiac-transplantation
#15
Marianne C Jacobsen, Maria D I Manunta, Emma S Pincott, Matthew Fenton, Gavin L Simpson, Nigel J Klein, Michael Burch
BACKGROUND: Cytomegalovirus (CMV) infection is implicated in endothelial dysfunction and graft damage after pediatric heart transplantation. CMV specific immune responses are thought to be necessary for CMV viral control but there is little data in pediatric heart transplantation. METHODS: We studied 28 consecutive pediatric heart transplant recipients for 1-year posttransplant. CMV-specific T cells expressing IFN-γ, TNF-α and IL-2 in response to ex-vivo stimulation with CMV lysates or peptides were measured...
March 5, 2018: Transplantation
https://www.readbyqxmd.com/read/29507857/importance-of-physical-capacity-and-the-effects-of-exercise-in-heart-transplant-recipients
#16
REVIEW
Marianne Yardley, Lars Gullestad, Kari Nytrøen
One of the most important prognostic factors in heart failure patients is physical capacity. Patients with very poor physical performance and otherwise eligible, may be listed as candidates for heart transplantation (HTx). After such surgery, life-long immunosuppression therapy is needed to prevent rejection of the new heart. The dark side of immunosuppression is the increased risk of infections, kidney failure, cancer and advanced atherosclerosis (cardiac allograft vasculopathy), with the two latter conditions as the main causes of later mortality...
February 24, 2018: World Journal of Transplantation
https://www.readbyqxmd.com/read/29505692/graft-derived-exosomes-when-small-vesicles-play-a-big-role-in-transplant-rejection
#17
EDITORIAL
Gilles Benichou, Aurore Prunevieille
Recipient pro-inflammatory T cells recognizing donor MHC molecules in a direct fashion trigger early acute rejection of cardiac allografts. In clinical settings, prevention of acute rejection is regularly achieved via continuous suppression of these T cells using immunosuppressive drugs, including calcineurin inhibitors. Nevertheless, within 5 years post-transplantation, up to 50% patients suffer late cardiac allograft failure whose major pathological manifestation is chronic allograft vasculopathy (CAV). CAV is characterized by intimal thickening, smooth muscle cell proliferation, and accumulation of extracellular matrix, which result in arterial narrowing and eventually graft ischemia and fibrosis...
March 5, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29492389/neonatal-heart-transplantation
#18
Mohan John, Leonard L Bailey
Neonatal heart transplantation was developed and established in the 1980's as a durable modality of therapy for complex-uncorrectable heart disease. Patients transplanted in the neonatal period have experienced unparalleled long-term survival, better than for any other form of solid-organ transplantation. However, the limited availability of neonatal and young infant donors has restricted the indications and applicability of heart transplantation among newborns in the current era. Indications for heart transplantation include congenital heart disease not amenable to other forms of surgical palliation, and cardiomyopathy, including some primary tumors...
January 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29492382/current-state-of-pediatric-cardiac-transplantation
#19
REVIEW
Anne I Dipchand
Pediatric heart transplantation is standard of care for children with end-stage heart failure. The diverse age range, diagnoses, and practice variations continue to challenge the development of evidence-based practices and new technologies. Outcomes in the most recent era are excellent, especially with the more widespread use of ventricular assist devices (VADs). Waitlist mortality remains high and knowledge of risk factors for death while waiting and following transplantation contributes to decision-making around transplant candidacy and timing of listing...
January 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29492381/percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-in-heart-transplant-recipients-with-coronary-allograft-vasculopathy-a-systematic-review-and-meta-analysis-of-1-520-patients
#20
REVIEW
Jessica G Y Luc, Jae Hwan Choi, Syed-Saif Abbas Rizvi, Kevin Phan, Ester Moncho Escrivà, Sinal Patel, Gordon R Reeves, Andrew J Boyle, John W Entwistle, Rohinton J Morris, H Todd Massey, Vakhtang Tchantchaleishvili
Background: Transplant coronary artery vasculopathy (TCAV) is the major cause of late allograft failure and death in heart transplant recipients. The aim of this systematic review was to examine the outcomes of percutaneous coronary interventions (PCIs) as compared to coronary artery bypass grafting (CABG) surgery in the management of TCAV. Our secondary objective was to compare the use and outcomes of drug eluting stents (DES) as compared to bare metal stents (BMS) in this patient population...
January 2018: Annals of Cardiothoracic Surgery
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