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Cardiac allograft vasculopathy

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https://www.readbyqxmd.com/read/28923645/comparison-of-segmental-versus-longitudinal-intravascular-ultrasound-analysis-for-pediatric-cardiac-allograft-vasculopathy
#1
M A Kuhn, M Burch, R E Chinnock, M J Fenton
Intravascular ultrasound (IVUS) has been routinely used in some centers to investigate cardiac allograft vasculopathy in pediatric heart transplant recipients. We present an alternative method using more sophisticated imaging software. This study presents a comparison of this method with an established standard method. All patients who had IVUS performed in 2014 were retrospectively evaluated. The standard technique consisted of analysis of 10 operator-selected segments along the vessel. Each study was re-evaluated using a longitudinal technique, taken at every third cardiac cycle, along the entire vessel...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28885488/complement-c1q-binding-de-novo-donor-specific-antibodies-and-cardiac-allograft-vasculopathy-in-pediatric-heart-transplant-recipients
#2
Bibhuti B Das, Chantale Lacelle, Song Zhang, Ang Gao, David Fixler
BACKGROUND: We hypothesized C1q binding de novo donor specific antibody (DSA) after heart transplant (HT) is a higher risk for development of coronary artery vasculopathy (CAV) in children. METHODS: A retrospective analysis of 127 pediatric heart transplant (HT) recipients transplanted between January 2005 and December 2014 was used to determine complement (C1q)-binding de novo DSA on the outcomes of HT and the ability of the C1q assay to predict CAV development...
September 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28865557/multimodality-noninvasive-imaging-in-the-monitoring-of-pediatric-heart-transplantation
#3
REVIEW
Steven J Kindel, Hao H Hsu, Tarique Hussain, Jonathan N Johnson, Colin J McMahon, Shelby Kutty
Orthotopic heart transplantation is a well-established and effective therapeutic option for children with end-stage heart failure. Multiple modalities, including noninvasive cardiac imaging, cardiac catheterization, angiography, and endomyocardial biopsy, are helpful to monitor these patients for graft dysfunction, rejection, and vasculopathy. Because of morbidities associated with invasive monitoring, noninvasive imaging plays a key role in the surveillance and evaluation of symptoms in pediatric transplant recipients...
September 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28865096/the-predictive-value-of-coronary-artery-calcium-detected-by-computed-tomography-in-a-prospective-study-on-cardiac-allograft-vasculopathy-in-heart-transplant-patients
#4
Anne Günther, Rune Andersen, Einar Gude, Jarl Jakobsen, Thor Edvardsen, Leiv Sandvik, Andreas Abildgaard, Lars Aaberge, Lars Gullestad
The predictive value of coronary artery calcium (CAC) in heart transplant (HTX) patients is not established. We explored if the absence of CAC on computed tomography (CT) could exclude moderate and severe cardiac allograft vasculopathy (CAV₂₋₃; the International Society for Heart and Lung Transplantation [ISHLT] recommended nomenclature) and significant coronary artery stenosis (diameter reduction ≥50%), and predict long-term clinical outcomes. HTX recipients (n=133) were prospectively included and underwent CT for CAC scoring and invasive coronary angiography (ICA) 7...
September 2, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28859788/outcomes-after-transplantation-of%C3%A2-donor%C3%A2-hearts-with-improving-left%C3%A2-ventricular-systolic%C3%A2-dysfunction
#5
MULTICENTER STUDY
Shivank Madan, Omar Saeed, Peter Vlismas, Ioanna Katsa, Snehal R Patel, Julia J Shin, William A Jakobleff, Daniel J Goldstein, Daniel B Sims, Ulrich P Jorde
BACKGROUND: Left ventricular systolic dysfunction (LVSD) accounts for almost 25% of nonacceptance of potential donor hearts. Previous smaller, single-center studies showed that LVSD following brain death may be transient, and such hearts can be successfully resuscitated with resolution of LVSD, then transplanted. OBJECTIVES: This study evaluated outcomes of donor hearts with LVSD on initial transthoracic echocardiogram (TTE) that resolved during donor management...
September 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28841655/lower-frequency-routine-surveillance-endomyocardial-biopsies-after-heart-transplantation
#6
Ludwig T Weckbach, Ulrich Maurer, Rene Schramm, Bruno C Huber, Korbinian Lackermair, Max Weiss, Bruno Meiser, Christian Hagl, Steffen Massberg, Sandra Eifert, Ulrich Grabmaier
In heart transplantation (HTx) patients, routine surveillance endomyocardial biopsies (rsEMB) are recommended for the detection of early cardiac allograft rejection. However, there is no consensus on the optimal frequency of rsEMB. Frequent rsEMB have shown a low diagnostic yield in the new era of potent immunosuppressive regimen. Efficacy and safety of lower frequency rsEMB have not been investigated so far. In this retrospective, single centre, observational study we evaluated 282 patients transplanted between 2004 and 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28838462/drug-eluting-balloons-a-new-tool-in-the-treatment-of-cardiac-allograft-vasculopathy-a-case-series
#7
B Skoric, J Bulum, M Cikes, H Jurin, D Lovric, J Ljubas-Macek, J Samardzic, M Pasalic, D Milicic
Percutaneous coronary intervention in patients with cardiac allograft vasculopathy is burdened with a lot of difficulties. Although they have allowed significant progress in comparison with plain balloon angioplasty and bare metal stents, drug-eluting stents have not fully overcome problems of diffuse lesions and small-vessel disease that are so common in transplant coronary artery disease. There is growing evidence that drug-eluting balloons might be a better choice for patients with small vessel atherosclerotic coronary disease and yet there is no experience with this technology in patients with cardiac allograft vasculopathy...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28838461/fever-malaise-and-dyspnea-in-a-diabetic-heart-transplant-patient-a%C3%A2-case-report
#8
A Alperi, I Pascual, B D Molina, I Silva, R Lorca, D Hernández-Vaquero, P Avanzas, J L Lambert, C M de la Tassa
Patients with solid-organ transplants usually present at the emergency department with nonspecific symptoms. The physician should consider a great variety of syndromes and diseases, given the greater risk that solid-organ transplant patients carry because of immunosuppression and transplant-related conditions. Myocardial infarction caused by cardiac allograft vasculopathy must be always suspected and ruled out, even when initial symptoms do not orientate in that direction. We present a case that conjugates signs that can be present in different pathologies...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28832763/methotrexate-associated-to-lipid-core-nanoparticles-improves-cardiac-allograft-vasculopathy-and-the-inflammatory-profile-in-a-rabbit-heart-graft-model
#9
A I Fiorelli, D D Lourenço-Filho, E R Tavares, P O Carvalho, A F Marques, P S Gutierrez, R C Maranhão, N A G Stolf
Coronary allograft vasculopathy is an inflammatory-proliferative process that compromises the long-term success of heart transplantation and has no effective treatment. A lipid nanoemulsion (LDE) can carry chemotherapeutic agents in the circulation and concentrates them in the heart graft. The aim of the study was to investigate the effects of methotrexate (MTX) associated to LDE. Rabbits fed a 0.5% cholesterol diet and submitted to heterotopic heart transplantation were treated with cyclosporine A (10 mg·kg-1·day-1 orally) and allocated to treatment with intravenous LDE-MTX (4 mg/kg, weekly, n=10) or with weekly intravenous saline solution (control group, n=10), beginning on the day of surgery...
August 17, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28822746/outcomes-of-early-adolescent-donor-hearts-in-adult-transplant-recipients
#10
Shivank Madan, Snehal R Patel, Peter Vlismas, Omar Saeed, Sandhya Murthy, Stephen Forest, William Jakobleff, Daniel Sims, Jacqueline M Lamour, Daphne T Hsu, Julia Shin, Daniel Goldstein, Ulrich P Jorde
OBJECTIVES: This study sought to determine outcomes of adult recipients of early adolescent (EA) (10 to 14 years) donor hearts. BACKGROUND: Despite a shortage of donor organs, EA donor hearts (not used for pediatric patients) are seldom used for adults because of theoretical concerns for lack of hormonal activation and changes in left ventricular mass. Nonetheless, the outcomes of adult transplantation using EA donor hearts are not clearly established. METHODS: All adult (≥18 years of age) heart transplant recipients in the United Network for Organ Sharing database between April 1994 and September 2015 were eligible for this analysis...
August 3, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28781013/early-aspirin-use-and-the-development-of-cardiac-allograft-vasculopathy
#11
Miae Kim, Brian A Bergmark, Thomas A Zelniker, Mandeep R Mehra, Garrick C Stewart, Deborah S Page, Erica L Woodcome, Jennifer A Smallwood, Steven Gabardi, Michael M Givertz
BACKGROUND: Cardiac allograft vasculopathy (CAV) remains a leading cause of morbidity and mortality after orthotopic heart transplantation (OHT). Little is known about the influence of aspirin on clinical expression of CAV. METHODS: We followed 120 patients with OHT at a single center for a median of 7 years and categorized them by the presence or absence of early aspirin therapy post-transplant (aspirin treatment ≥6 months in the first year). The association between aspirin use and time to the primary end-point of angiographic moderate or severe CAV (International Society for Heart and Lung Transplantation grade ≥2) was investigated...
July 3, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28775077/chronic-rejection-of-cardiac-allografts-is-associated-with-increased-lymphatic-flow-and-cellular-trafficking
#12
Lindsey A Edwards, Anna K Nowocin, Nazila V Jafari, Lucy Meader, Kathryn Brown, Aurélien Sarde, Carolyn Lam, Alex Murray, Wilson Wong
Background -Cardiac transplantation is an excellent treatment for end-stage heart disease. However, rejection of the donor graft, particularly by chronic rejection leading to cardiac allograft vasculopathy, remains a major cause of graft loss. The lymphatic system plays a crucial role in the alloimmune response, facilitating trafficking of antigen presenting cells (APCs) to draining lymph nodes (dLN). The encounter of APCs with T lymphocytes in secondary lymphoid organs is essential for the initiation of alloimmunity...
August 3, 2017: Circulation
https://www.readbyqxmd.com/read/28754566/impact-of-asymmetric-dimethylarginine-on-coronary-physiology-early-after-heart-transplantation
#13
RANDOMIZED CONTROLLED TRIAL
Rushi V Parikh, Kiran K Khush, Helen Luikart, Vedant S Pargaonkar, Yuhei Kobayashi, Jang Hoon Lee, Seema Sinha, Garrett Cohen, Hannah A Valantine, Alan C Yeung, William F Fearon
Cardiac allograft vasculopathy is a major cause of long-term graft failure following heart transplantation. Asymmetric dimethylarginine (ADMA), a marker of endothelial dysfunction, has been mechanistically implicated in the development of cardiac allograft vasculopathy, but its impact on coronary physiology early after transplantation is unknown. Invasive indices of coronary physiology, namely, fractional flow reserve (FFR), the index of microcirculatory resistance, and coronary flow reserve, were measured with a coronary pressure wire in the left anterior descending artery within 8 weeks (baseline) and 1 year after transplant...
September 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28708333/conversion-from-calcineurin-inhibitors-to-mtor-inhibitors-as-primary-immunosuppressive-drugs-in-pediatric-heart-transplantation
#14
Alfred Asante-Korang, Jennifer Carapellucci, Diane Krasnopero, Abigail Doyle, Brian Brown, Ernest Amankwah
There are only a few reports of successful use of mammalian target of rapamycin (mTORI) as primary immunosuppression in pediatric heart transplantation. Compared to calcineurin inhibitors, mTORI have less side effects, especially nephrotoxicity, infections, and malignancies. A retrospective study was conducted at our institution of all 170 heart transplants from 1995 to 2015. Nineteen patients were switched from tacrolimus (n=15) or cyclosporin (n=4) to everolimus (n=4) or sirolimus (n=15) due to nephrotoxicity (n=5), malignancy (n=8), EBV viremia/reactive plasmacytic changes (n=5), and immune hemolytic anemia (n=1)...
July 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28672061/thalidomide-treatment-prevents-chronic-graft-rejection-after-aortic-transplantation-in-rats
#15
Katharine K Miller, Dong Wang, Xiaomeng Hu, Xiaoqin Hua, Tobias Deuse, Evgenios Neofytou, Thomas Renne, Joachim Velden, Hermann Reichenspurner, Sonja Schrepfer, Daniel Bernstein
BACKGROUND: Cardiac allograft vasculopathy (CAV) affects approximately 30% of cardiac transplant patients at five years post-transplantation. To date there are few CAV treatment or prevention options, none of which are highly effective. The aim of the study was to investigate the effect of thalidomide on the development of CAV. METHODS: The effect of thalidomide treatment on chronic rejection was assessed in rat orthotopic aortic transplants in allogeneic F344 or syngeneic Lew rats (n=6/group)...
July 3, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28627046/donor-specific-antibodies-are-associated-with-micro-and-macrovascular-coronary-disease-restrictive-myocardial-damage-and-poor-outcome-in-heart-transplanted-patients
#16
Tor Skibsted Clemmensen, Pernille Koefoed-Nielsen, Lis-Ann Jensen, Steen Hvitfeldt Poulsen, Niels Ramsing Holm, Brian Bridal Løgstrup, Evald Høj Christiansen, Jouke Dijkstra, Kamilla Pernille Bjerre Valen, Hans Eiskjaer
AIMS: We examined the relationship between donor-specific HLA antibody (DSA) presence and graft function, hemodynamics, cardiac allograft vasculopathy (CAV), and major adverse cardiac events (MACE) in stable long-term heart-transplanted (HTx) patients. METHODS: Sera from 79 patients (median 7.5 years after HTx) were analyzed for DSA presence. Graft function was evaluated by echocardiography and right heart catheterization. CAV burden was determined by coronary angiography, optical coherence tomography (OCT), and coronary flow velocity reserve (CFVR)...
June 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28595701/angiotensin-converting-enzyme-inhibitors-for-cardiac-allograft-vasculopathy-after-heart-transplantation
#17
EDITORIAL
Howard J Eisen, Shelley Hankins, Denise Wang
No abstract text is available yet for this article.
June 13, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28595700/angiotensin-converting-enzyme-inhibition-early-after-heart-transplantation
#18
RANDOMIZED CONTROLLED TRIAL
William F Fearon, Kozo Okada, Jon A Kobashigawa, Yuhei Kobayashi, Helen Luikart, Sean Sana, Tiffany Daun, Steven A Chmura, Seema Sinha, Garett Cohen, Yasuhiro Honda, Michael Pham, David B Lewis, Daniel Bernstein, Alan C Yeung, Hannah A Valantine, Kiran Khush
BACKGROUND: Cardiac allograft vasculopathy (CAV) remains a leading cause of mortality after heart transplantation (HT). Angiotensin-converting enzyme inhibitors (ACEIs) may retard the development of CAV but have not been well studied after HT. OBJECTIVES: This study tested the safety and efficacy of the ACEI ramipril on the development of CAV early after HT. METHODS: In this prospective, multicenter, randomized, double-blind, placebo-controlled trial, 96 HT recipients were randomized to undergo ramipril or placebo therapy...
June 13, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28580728/late-graft-failure-in-heart-transplant-recipients-incidence-risk-factors-and-clinical-outcomes
#19
Ángela López-Sainz, Eduardo Barge-Caballero, Gonzalo Barge-Caballero, David Couto-Mallón, María J Paniagua-Martin, Leticia Seoane-Quiroga, Carmen Iglesias-Gil, José M Herrera-Noreña, José J Cuenca-Castillo, José M Vázquez-Rodríguez, María G Crespo-Leiro
AIM: To analyse the incidence, risk factors and clinical outcomes of late graft failure after heart transplantation. METHODS AND RESULTS: We conducted an observational, single-centre study based on 547 patients who underwent cardiac transplantation from 1991 to 2014 and who survived the in-hospital postoperative period. Late graft failure was defined as the first hospitalization due to this condition after discharge. Over a mean follow-up of 8.4 ± 6, 178 (32...
June 5, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28579240/first-observation-of-a-golden-tube-after-complete-resorption-of-a-bioresorbable-vascular-scaffold-in-a-transplanted-patient-with-cardiac-allograft-vasculopathy
#20
Flavio Ribichini, Roberto Scarsini, Claudia Zanetti, Gabriele Pesarini
No abstract text is available yet for this article.
May 25, 2017: JACC. Cardiovascular Interventions
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